摘要
目的观察新生儿发生食物过敏的临床特点。方法选取2013年1月至2015年1月在北京大学第三医院住院临床诊断为新生儿食物过敏的患儿10例，观察分析以下几个方面：胎龄、性别、发病日龄、发病时喂养方式、临床表现、白细胞计数、嗜酸性粒细胞计数、C反应蛋白（CRP）、便常规加潜血试验、血清牛奶蛋白特异性IgE检测以及预后追踪。结果共纳入观察新生儿10例，其中足月儿4例，早产儿6例（其中包括2例超未成熟儿）；男女比例为7：3；发病日龄1～43d，平均发病日龄20．3d，中位数18．5d，标准差13．38d。6例早产儿发病时矫正胎龄30～37周。发病时喂养方式为母乳喂养4例，配方奶喂养3例，混合喂养3例。发病时临床表现一般状况均良好，症状以消化道受累为主。实验室检查中，外周血白细胞计数均在正常范围；嗜酸性粒细胞计数升高8例；CRP升高1例，余9例正常；牛奶蛋白特异性IgE升高1例，余9例正常。2例患儿行开放性食物激发试验阳性。结论新生儿发生食物过敏中早产儿、足月儿均可发病，发病日龄不等；纯母乳喂养儿也可发生食物过敏；新生儿发生食物过敏时一般以消化道表现为主。临床中开放性食物激发试验有助于确诊食物过敏，但在新生儿实践有难度；饮食治疗是目前唯一疗效确切的治疗方式，经过治疗，新生儿食物过敏大多预后良好。
Objective To find out the clinical characteristics related to neonate food allergy. Methods Ten subjects were diagnosed as neonate food allergy at the Third Hospital of Peking University from January 2013 to January 2015. The following clinical data： the gestational age, genter, age of onset, feeding, clinical manifestations, white blood cell count, eosinophilic granulocyte count, C -reactive protein （CRP）, routine stool test and occult blood test, blood specific IgE of cow＇s milk and clinical outcomes were investigated. Results There were 4 term infants,and 6 preterm infants ,including 2 very -preterm subjects. The gender ratio between male and female cases was 7 ： 3. The age of onset from 1 day after birth to 43 days after birth, clinical investigation of neonate food allergy in 10 cases, and the average time was 20.3 d,the median age was 18.5 d,and the SD was 13.38 d. Their rectified gestational ages were from 30 to 37 weeks in 6 cases at onset. Four infants received breast feeding,3 infants received formula milk feeding,and the other 3 infants received mixed feeding. At onset, the symptoms were almost involved in the digestive system. The white blood cell counts of lab test were almost normal in 10 subjects. And eosinophilic granulocytes were elevated in 8 subjects. CRP elevated in 1 case,and those of the other 9 subjects were normal. The cow＇s milk specific IgE antibody was elevated in 1 subject, and that of the other 9 subjects was normal. Two subjects were performed opened food challenge test and the finding were positive. Conclusions Both the term infants and the preterm infants can have food allergy, but the age of onset ranged widely. Breast feeding infants can also be attacked. The symptoms of the digestive tract were the main clinical manifestations of such neonates. The open - food challenge test is beneficial to diagnose but difficult to practice in the neonates. Dietetic treatment is the only method can therapy the disease. And mostly the clinical outcomes are desirable.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2016年第2期112-115,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
北京市自然科学基金（7132213）
