摘要
目的分析婴幼儿牛奶蛋白过敏(cow′s milk protein allergy,CMPA)的临床特点与危险因素,为婴幼儿CMPA防治提供依据。方法回顾性分析2017年1月至2018年12月在本院儿童保健科门诊首诊的CMPA患儿93例,另选取同期排除CMPA的体检婴幼儿186例为对照组。统计患儿特征、家族史以及实验室检查如血嗜酸性粒细胞和血清牛奶蛋白特异性sIgE水平等,应用Logistic多元逐步回归法确定CMPA危险因素。结果CMPA组与对照组婴幼儿性别、年龄与对照组差异无统计学意义(P>0.05)。单因素分析显示两组剖宫产、纯母乳喂养、部分母乳喂养、人工喂养、维生素D不足、维生素D缺乏、家族过敏性疾病史、血嗜酸性粒细胞增多及血清牛奶蛋白sIgE阳性差异有统计学意义(P<0.05)。多因素分析显示剖宫产、纯母乳喂养、维生素D不足、家族过敏史、血嗜酸性粒细胞增多、血清牛奶蛋白sIgE阳性是婴幼儿CMPA的危险因素;纯母乳喂养、维生素D缺乏是重度婴幼儿CMPA的危险因素。结论剖宫产、纯母乳喂养、维生素D不足、家族过敏史、血嗜酸性粒细胞增多、血清牛奶蛋白sIgE阳性是婴幼儿CMPA危险因素;纯母乳喂养、维生素D缺乏是重度婴幼儿CMPA危险因素,对危险因素的干预可能有助改善患儿病情。
Objective To analyze the clinical characteristics and risk factors in infants with Cow′s milk protein allergy(CMPA),and provide the evidence for the prevention and treatment of CMPA.Methods 93 in?fants diagnosed as CMPA for the first visit in the child care clinic,and 186 non?CMPA infants for physical exami?nation as the control group from January 2017 to December 2018 were retrospectively analyzed.Data including clini?cal characteristics,family history,and laboratory tests such as blood eosinophils and serum milk protein?specific IgE levels were collected.Logistic regression with stepwise method was employed to determine the risk factors for CMPA.Results There were no statistically significant differences in gender and age between the CMPA group and the control group(P>0.05).Univariate analysis showed that cesarean section,exclusive breastfeeding,partial breastfeeding,artificial feeding,vitamin Dinsufficiency,vitamin D deficiency,family history of allergic disease,blood eosinophilia,and positive serum milk protein sIgE were statistically significant differences between the two groups(P<0.05).Multivariate analysis showed that cesarean section,exclusive breastfeeding,vitamin D insuffi?ciency,family allergy history,blood eosinophilia,and positive serum milk protein IgE were the independent risk factors for infant CMPA.Additionally,exclusive breastfeeding,and vitamin D deficiency were the independent risk factors for severe infant CMPA.Conclusions Cesarean section,exclusive breastfeeding,vitamin D insufficiency,family allergy history,blood eosinophilia,and positive serum milk protein sIgE were the independent risk factors for infant CMPA;exclusive breastfeeding,and vitamin D deficiency were the independent risk factors for severe in?fant CMPA.Interventions against the risk factors may contribute to improve the disease condition of infants.
作者
韦茹
王静
杨延萍
肖玉联
陈力
谭美珍
WEI Ru;WANG Jing;YANG Yanping;XIAO Yulian;CHEN Li;TAN Meizhen(Department of Child Health Care,Guangzhou Women and Children′s Medical Center,Guangzhou 510623,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第21期3322-3326,共5页
The Journal of Practical Medicine
基金
广东省医学科学技术研究基金项目(编号：A2018239)
广州市医药卫生科技项目(编号：20181A011029)
