Abstract 【Objective】To analyze the clinical characteristics of milk protein allergic proctocolitis (AP) in premature infants with bloody stools as the main symptom. 【Methods】A retrospective analysis was conducted on the clinical data of 6 premature infants who were diagnosed with AP and admitted to the neonatology department of our hospital from January 2023 to September 2023. The clinical characteristics of AP in premature infants were analyzed and summarized. 【Results】All 6 premature infants were initially considered to have necrotizing enterocolitis due to varied degrees of bloody stools appeared within the first 4 to 49 days of birth. Among them, 4 cases were accompanied by abdominal distension, 2 cases were accompanied by elevated eosinophil count, 3 cases had abnormal infection indicators, 1 case had intestinal wall gas accumulation on abdominal plain film, 1 case had portal vein gas accumulation, 2 cases had mild intestinal dilation, but both abdominal ultrasound and bowel sounds were normal. Six premature infants had a good prognosis after being fed with a deeply hydrolyzed formula. 【Conclusion】For premature infants with rectal bleeding, attention should be paid to AP, clinicians need to repeatedly assess and avoid misdiagnosis.
[1] 陈平洋.母乳喂养对早产儿脑发育的深远影响[J].医学临床研究, 2020,37(12):1761-1767.
[2] BURRIS A D, BURRIS J, JÄRVINEN K M. Cow's milk protein allergy in term and preterm infants: clinical manifestations, immunologic pathophysiology, and management strategies[J].Neoreviews,2020,21(12):e795-e808.
[3] KIM Y I, JOO J Y, JUNG Y H, et al. Differentiation of food proteininduced enterocolitis syndrome misleading to necrotizing enterocolitis[J].Ann Allergy Asthma Immunol,2022,128(2):193198.
[4] MORITA Y, IWAKURA H, OHTSUKA H, et al. Milk allergy in the neonatal intensive care unit: comparison between premature and fullterm neonates[J].Asia Pac Allergy,2013, 3(1):3541.
[5] 陈样,夏世文,祝华平,等.新生儿牛奶蛋白过敏性直肠结肠炎11例临床分析[J].中华新生儿科杂志,2021,36(3):8-13.
[6] 中华医学会儿科学分会新生儿学组.新生儿牛奶蛋白过敏诊断与管理专家共识(2023)[J].中华儿科杂志,2024,62 (1):12-21.
[7] 中国医师协会新生儿科医师分会循证专业委员会.新生儿坏死性小肠结肠炎临床诊疗指南(2020)[J].中国当代儿科杂志,2021,23(1):1-11.
[8] FLOM J D, SICHERER S H. Epidemiology of cow's milk allergy[J].Nutrients,2019, 11(5):1051.
[9] LABROSSE R, GRAHAM F, CAUBET J C. Non-IgE-mediated gastrointestinal food allergies in children: an update[J].Nutrients,2020, 12(7):2086.
[10] 姜雅楠,邢燕.早产儿牛奶蛋白过敏诊疗进展[J].中华预防医学杂志, 2021, 55(5): 583591.
[11] YANG M,TAN M Z,WU J L, et al. Prevalence, characteristics, and outcome of cow's milk protein allergy in Chinese infants: a population-based survey[J].JPEN J Parenter Enteral Nutr,2019,43(6):803-808.
[12] DEBUF M J,CLAEYS T,STALENS J P,et al.Hematochezia caused by eosin-ophilic proctcolitis in a newborn before oral feeding:a case report[J].J Med Case Rep,2017,11(1):160.
[13] VARDAR G, OZDIL M, TUFEKCI S. Awareness or neglecting the diagnosis of cow milk protein allergy in the neonatal period[J].Asia Pac J Clin Nutr,2023,32(2):257264.
[14] FERRETTI E, PILON S, BOLAND M, et al. Early onset allergic proctitis in a preterm neonatea case report and review of the literature[J].Pediatr Dev Pathol,2019, 22(2):152156.
[15] CORDOVA J,SRIRAM S,PATTON T, et al. Manifestations of cow's-milk protein intolerance in preterm infants [J].J Pediatr Gastroenterol Nutr,2016,62(1):140-144.
[16] 孙欢,李禄全,包蕾.以血便为首发症状的新生儿坏死性小肠结肠炎与食物蛋白过敏性直肠结肠炎的临床对比分析[J].第三军医大学学报,2020,42(20):2063-2068.
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2024, Vol. 41 
