摘要 肠内外营养在早产儿早期生长发育过程中发挥重要作用,牛奶蛋白是早产儿肠内营养的主要蛋白质来源。早产儿牛奶蛋白过敏(cow′s milk protein allergy,CMPA)发生率虽然相对低,但症状不典型,易与其他疾病混淆,导致实施不恰当的诊疗措施,严重影响早产儿生长发育和预后。因此,本文通过阐述早产儿CMPA的流行病学、临床表现、辅助检查、诊断及鉴别诊断、治疗及预防研究进展,发现早产儿CMPA起病时间晚,单纯表现为直肠出血者较少,表现胆汁样呕吐及类似于坏死性小肠结肠炎的症状更为常见,主要依据诊断性回避试验做出诊断,对于确诊CMPA的患儿,应通过母亲饮食回避、更换为深度水解配方奶或氨基酸配方奶治疗。但就如何早期识别早产儿CMPA仍然需要深入的临床和基础研究。 Parenteral nutrition plays an important role in the early growth and development of preterm infants.Milk protein is the main protein source for enteral nutrition in preterm infants.Although the incidence of cow′s milk protein allergy(CMPA)in preterm infants is relatively low,the symptoms are atypical and easily confused with other diseases,leading to incorrect diagnosis and treatment measures,and seriously affecting the growth,development and prognosis of preterm infants.This article reviews the epidemiology,clinical manifestations,auxiliary examination,diagnosis and differential diagnosis,treatment and prevention of CMPA in premature infants.The onset of CMPA in premature infants was late.Few patients had rectal bleeding,and bile-like vomiting and symptoms similar to necrotizing enterocolitis were more common.The diagnosis is mainly based on the avoidance test.For children diagnosed with CMPA,they should be avoided through the mother′s diet or replaced with deep hydrolyzed formula milk or amino acid formula milk.However,in-depth clinical and basic research is still needed on how to identify CMPA in preterm infants early.
机构地区 北京大学第三医院儿科
出处 《中华预防医学杂志》 CAS CSCD 北大核心 2021年第5期583-591,共9页 Chinese Journal of Preventive Medicine
基金 北京市自然-三元联合科学基金(S170003) 北京大学第三医院优秀留学回国人员科研启动基金(BYSYLXHG2019005)。
分类号 R72 [医药卫生—儿科]
