Clinical Analysis Of Food Protein-induced Proctocolitis And Neonatal Necrotizing Enterocolitis In Neonatal Blood Stool

Objective: To analyze the clinical characteristics of food protein-induced proctocolitis(FPIPC)and neonatal necrotizing enterocolitis(NEC)in outpatients with blood stool as the first manifestation.Methods: The clinical data of neonates with FPIPC and NEC with bloody stool as the first symptom in outpatient clinic from January2018 to December 2018 were analyzed retrospectively.The t-test,rank sum test or chi-square test was used to analyze the clinical symptoms and signs,laboratory parameters and imaging results,treatment and prognosis of the two groups.Results: There were 207 neonates with blood and stool as the first symptom,including 150 FPIPC and 57 NEC.The incidence of diarrhea and fecal fat globule in FPIPC group was higher than thatin NEC group(59.3%vs.35.1%,33.3%vs.10.5%,P<0.05).The level of blood eosinophils in FPIPC group was higher than that in NEC group(0.08 vs.0.03,P < 0.05).Compared with FPIPC group,NEC group had more small for gestational age,earlier onset,more prone to abdominal distension,vomiting,fever,higher C-reactive protein,hihger white blood cell level in feces,and higher proportion of pneumatosis intestinalis or portal venous gas[15.8%vs.5.3%,11(7~17)days vs.15(10~21)days,24.6%vs.2.0%,29.8%vs.10.0%,14.0%vs.4.0%,14.0%vs.1.3%,50.9%vs.30.0%,64.9%vs.27.3%,P<0.05]?Conclusion: Among the neonates admitted to the hospital with bloody stool as the first manifestation in the outpatient clinic,there were smaller for gestational age,the age of onset was earlier,the proportion of increased CRP was higher,and it was more likely to be complicated with septicemia in NEC.The eosinophils were elevated in the neonates with FPIPC.At the same time,neonate with FPIPC could still occur pneumatosis intestinalis and portal gas accumulation.