牛奶蛋白过敏诊治.pptxVIP

牛奶蛋白过敏诊治牛奶蛋白过敏诊治在婴儿和低龄小朋友CMPA/I是最常见食物不良反应5%-15%小朋友存在着疑似CMPA/I症状发病率实际为2%-3%（激发试验成果）牛奶蛋白过敏或不耐受（CMPA/I）发生率牛奶蛋白过敏诊治第1页牛奶蛋白过敏或不耐受（CMPA/I）发生率在婴儿和低龄小朋友CMPA/I是最常见食物不良反应5%-15%小朋友存在着疑似CMPA/I症状发病率实际为2%-3%（激发试验成果）第2页小朋友牛奶蛋白过敏和不耐受（CMPA/I）与特应性疾病临床过程1749婴儿（1年中出生）117（6.7%）CMPA/I疑似症状78未确诊CMPA/I39（2.2%）（1.5-2.9%）确诊CMPA/I9（0.5%）（0.2-0.9%）CMPA/I母乳可抗CMPFig. 1. Prospective study of 1-year birth cohort from 1985 in Odense, Denmark. CMP, cow’s milk protein; CMPA/I, cow’s milk protein allergy/intolerance. Some 117/1749 (6.7%) had symptoms suggestive of cow’s milk protein allergy/intolerance (CMPA/I) during the first year of life. Based on controlled milk eliminations and challenge procedure the diagnosis of CMPA/I was confirmed in 39/117, resulting in a 1-year incidence of CMPA/I of 2.2% with 95% confidence interval of 1.5–2.9%. Nine of 39 infants with CMPA/I were confirmed to react against cow’s milk protein in human milk, corresponding to 0.5% of the birth cohort (95% confidence interval of 0.2–0.9%)Host A, et al. Clinical course of cow’s milk protein allergy/ intolerance and atopic diseases in childhood. Pediatr Allergy Immunol, 2023, 13(Suppl. 15): 23–28第3页CMPA/I预后（1）Host A, et al. Clinical course of cow’s milk protein allergy/ intolerance and atopic diseases in childhood. Pediatr Allergy Immunol, 2023, 13(Suppl. 15): 23–28第4页CMPA/I预后（2）Host A, et al. Clinical course of cow’s milk protein allergy/ intolerance and atopic diseases in childhood. Pediatr Allergy Immunol, 2023, 13(Suppl. 15): 23–28第5页CMPA/I预后（3）Host A, et al. Clinical course of cow’s milk protein allergy/ intolerance and atopic diseases in childhood. Pediatr Allergy Immunol, 2023, 13(Suppl. 15): 23–28第6页病史发病年纪、临床体现、饲养史、辅食添加时间、食物或其他原因所致有关症状、家族或个体特应性疾病史体格检查检查食物过敏体征、与有关疾病鉴别筛查试验血清总IgE、嗜酸细胞、血清特异性IgE、SPT、斑贴试验、膳食回避试验*必要行胃肠病学试验（内窥镜、组织学、炎性标识、胃肠动力）诊断确定对照口服激发试验Fig1 疑似食物过敏患儿临床评定Canani RB,et al. The diagnosis of food allergy in children. Curr Opin Pediatr, 20: 584-589第7页牛乳蛋白过敏体现 (CMPA)大多数婴儿有二种或更多症状症状:呕吐, 胃肠道症状: 食用后最快1-2小时腹泻: 食用后2-6 小时大多