摘要
Abstract
Objective To study the influencing factors and clinical characteristics of cow's milk protein al-lergy(CMPA)in infants aged 0-3 years in Xuzhou area,and to provide evidence-based medical evidence for clinical diagnosis and treatment.Methods The infants aged 0-3 years in Xuzhou area from October 2019 to October 2022 were selected as objects.Clinical characteristics of all objects were collected by questionnaire,and the nutritional level was assessed and laboratory test was conducted.Children with CMPA were diagnosed according to the results of skin prick test and milk avoidance/excitation test,severity of the condition was as-sessed and clinical features and influencing factors of CMPA were analyzed.The severity of the disease was e-valuated and the clinical characteristics and influencing factors of CMPA were analyzed.The children were di-vided into immunoglobulin E(IgE)mediated type and non-IgE mediated type according to the results of skin prick test and IgE examination,and the clinical symptoms and laboratory test results of different types of chil-dren were compared.Results A total of 4 983 infants aged 0-3 years old were enrolled in the study.124 ca-ses of CMPA were detected among 4 983 infants,with the prevalence rate of 2.49%.The prevalence rate of CMPA infants with different ages had statistically significant difference(χ2 =10.065,P=0.002),and the prevalence rate of CMPA in infants aged 1-2 years and>2 years was higher than that in infants aged<1 year(χ2=5.258,P=0.022;χ2=8.055,P=0.005).The prevalence rates of CMPA in premature infants and infants with history of parental allergy were higher than those in on-preterm infants and infants without histo-ry of parental allergy(χ2 =6.881,P=0.009;χ2 =9.753,P=0.002).Among the 124 children with CMPA,there were 26 cases(20.97%)of IgE mediated type and 98 cases(79.03%)of non-IgE mediated type.The in-cidence rate of vomiting/gastroesophageal reflux in IgE mediated type was significantly lower than that in non-IgE mediated type(χ2=11.668,P=0.001),while the incidence rates of eczema/wheal/erythema,runny nose/cough/wheezing,perioral swelling and involvement of two or more systems were significantly higher than those in non-IgE mediated type(χ2=32.975,P<0.001;χ2=10.000,P=0.002;χ2=17.293,P<0.001;χ2=4.908,P=0.027).The positive rates of total IgE and milk protein sIgE in IgE mediated type were signif-icantly higher than those in non-IgE mediated type(χ2=19.855,P<0.001;χ2=50.077,P<0.001).Multiva-riate Logistic regression analysis showed that infants aged<1 year(OR=4.674,95%CI:2.890-7.560),pre-mature birth(OR=3.077,95%CI:1.669-5.674)and parental history of allergy(OR=3.908,95%CI:2.236-6.830)were risk factors of CMPA(P<0.05).Conclusion The prevalence rate of CMPA in infants aged 0-3 years in Xuzhou area decreases with the increase of age.Premature infants and their parents'history of allergy may lead to the increase of prevalence rate,and the symptoms and signs of children with different types of CMPA vary greatly.It is of important reference significance to distinguish the symptoms and labora-tory test results of children in detail for formulating reasonable treatment measures.关键词
牛奶蛋白过敏/婴幼儿/免疫球蛋白E/流行病学/临床特征Key words
cow's milk protein allergy/infants/immunoglobulin E/epidemiology/clinical charac-teristics分类
医药卫生
