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目的分析牛奶蛋白过敏(CMPA)儿童基本情况,探讨个体化应用氨基酸配方粉、深度水解乳清蛋白婴儿配方粉治疗后的干预效果及转归。方法收集2009年2-12月在中国医科大学附属盛京医院儿科就诊,符合CMPA诊断的180例患儿为干预对象。在营养门诊对其喂养史、一般情况进行回顾性分析,给予牛奶回避及治疗类配方粉营养干预7 d后回访疗效,指导辅食的选择和添加,并随访3个月、6个月后配方粉喂养婴儿的变化及疗效。结果 180例患儿牛奶过敏高发年龄段为>2～4月龄组(64例,占35.5%);母乳喂养者21例(11.7%),非纯母乳喂养者159例(88.3%);有家族史者32例(17.8%);男女比为1.651。干预7 d后显效比例最高的临床症状为腹泻(61例,占83.6%)。3个月后纯氨基酸配方粉喂养76例(占46.0%),深度水解配方喂养54例(占32.7%),适度水解配方奶粉喂养为25例(占15.3%)。6个月后喂养主要是纯氨基酸配方(39例,占24.9%),其次为牛奶配方粉(36例,占22.9%)。结论母乳喂养有利于避免婴儿牛奶过敏,营养干预3个月内不宜喂养含牛奶蛋白配方奶粉,营养干预6个月后部分患儿可获牛奶耐受。牛奶过敏患儿喂养配方粉的转归各不相同,应结合患儿家庭经济能力、病情变化等个体化营养干预。
Objective To analyze the basic situation of children with milk protein allergy (CMPA) and to explore the intervention effect and outcome of the individualized application of amino acid formula powder and deep hydrolyzed whey protein infant formula powder. Methods Totally 180 pediatric patients with CMPA diagnosis were enrolled in pediatric department of Shengjing Hospital affiliated to China Medical University from February to December in 2009. The feeding history of their nutrition, retrospective analysis of the general situation, to give milk avoidance and treatment of formula powder nutrition intervention 7 d after the visit efficacy, guide the choice of complementary food and add, and follow-up 3 months, 6 months after the formula powder Feeding baby changes and efficacy. Results 180 cases of high-risk milk allergy in children aged> 2-4 months (64 cases, 35.5%); breastfeeding 21 cases (11.7%), non-exclusive breastfeeding 159 cases (88.3%); Family history in 32 cases (17.8%); male to female ratio was 1.65 1. After 7 days of intervention, the most clinically significant symptom was diarrhea (61 cases, 83.6%). Three months later, pure amino acid formula powder was fed in 76 cases (46.0%), deep hydrolysis formula in 54 cases (32.7%) and moderate hydrolysis formula in 25 cases (15.3%). Feeding after 6 months was mainly pure amino acid formula (39 cases, accounting for 24.9%), followed by milk formula powder (36 cases, accounting for 22.9%). Conclusion Breastfeeding helps to avoid milk allergy in infants. Nutritional intervention should not be given milk formula milk powder within 3 months. Some children may receive milk tolerance after 6 months of nutritional intervention. Milk allergy children fed formulas vary, should be combined with children’s family economic ability, disease changes and other individual nutrition intervention.