COWS MILK PROTEIN INTOLERANCE IN INFANTS UNDER 1-YEAR-OF-AGE - A PROSPECTIVE EPIDEMIOLOGIC-STUDY
COWS MILK PROTEIN INTOLERANCE IN INFANTS UNDER 1-YEAR-OF-AGE - A PROSPECTIVE EPIDEMIOLOGIC-STUDY
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DOI：
10.1007/bf01955238
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发表时间：
1993-08-01
影响因子：
3.6
通讯作者：
KESTER, ADM
中科院分区：
文献类型：
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作者：
SCHRANDER, JJP;VANDENBOGAR, JPH;KESTER, ADM
对1158例新生儿进行了牛奶蛋白不耐受（CMPI）发生率及临床表现的前瞻性研究。914名婴儿作为健康对照，不需要改变食物。当怀疑CMPI时（211名婴儿），根据标准方案进行诊断性饮食干预。排除乳糖不耐受后，两个阳性牛奶消除/激发试验被认为是CMPI的诊断。对211名有症状的婴儿进行了可能的CMPI检查。一大群80名婴儿改善了乳糖减少配方奶粉。在87/211名婴儿中，CMPI被排除（患病对照）。最终在26名婴儿中证实了CMPI。计算的CMPI发生率为2.8%。CMPI患儿的主要症状为消化道、皮肤和呼吸道疾病，分别占50%、31%和19%。与健康对照组（35%）或低乳糖配方奶粉改善的婴儿（51%）相比，CMPI婴儿（65%）或患病对照组（63%）中的特应性阳性家族史（一级或二级亲属）更常见。CMPI患儿与对照组之间的差异仅在于至少有2名一级亲属存在特应性[CMPI患儿组5/26，对照组4/87（P < 0.05）]和多器官受累[CMPI患儿组10/26，对照组12/87（P < 0.02）]。这些统计学差异太弱，不具有临床价值。
Incidence and clinical manifestation of cow's milk protein intolerance (CMPI) were studied in 1158 unselected newborn infants followed prospectively from birth to 1 year of age. No food changes were required in 914 infants who were used as healthy controls. When CMPI was suspected (211 infants), diagnostic dietary interventions according to a standard protocol were performed. After exclusion of lactose intolerance, two positive cow's milk elimination/challenge tests were considered diagnostic of CMPI. Two hundred and eleven symptomatic infants were examined for possible CMPI. A large group of 80 infants improved on a lactose reduced formula. In 87/211 infants CMPI was excluded (sick controls). Finally CMPI was proven in 26 infants. The calculated incidence rate for CMPI was 2.8%. The principal symptoms in infants with CMPI were gastrointestinal, dermatological and respiratory in 50%, 31% and 19% respectively. A positive family history for atopy (first or second degree relatives) was more frequent in either CMPI infants (65%), or sick controls (63%) when compared to either healthy controls (35%) or infants improving on a low lactose formula (51%). Differences between patients with CMPI and sick controls were only found for the presence of atopy in at least 2 first degree relatives [(5/26 in CMPI infants and 4/87 in sick controls (P < 0.05)] and for multiorgan involvement [10/26 infants with CMPI as opposed to 12/87 in the sick control group (P < 0.02)]. These statistical differences are too weak to be of clinical value.