Analysis Of High-risk Factors And Follow-up Study On Infants With Hematochezia As The Main Manifestations Due To Cow’s Milk Protein Allergy

Objectives:To explore the high-risk factors and treatment prognosis of infants with hematochezia as the main clinical manifestation duo to cow’s milk protein allergy(CMP A),and to compare the treatment and prognosis of infants with CMPA with different treatment methods,so as to help parents avoid high-risk factors to reduce the prevalence and help clinicians make the best diagnosis and treatment measures.Methods:From the 119 cases with hematochezia as the main clinical manifestation,45 cases infants who would like to receive follow-up and diagnosed CMPA as study objects(group)from September 2018 to September 2020 at the Pediatric Outpatient Clinic of the First Affiliated Hospital of Kunming Medical University.47 healthy infants who had no allergic symptoms in the Department of Prevention and Health of the First Affiliated Hospital of Kunming Medical University during the same period were used as the control group.Collect information on the follow-up form for infants with CMPA in the study group and the control group,information including medical history,clinical manifestations,blood routine,growth and development,etc.,and use the anxiety questionnaire to investigate and evaluate the anxiety level of the mother;Using a case-control study to find the high-risk factors of CMPA;According to different feeding methods,the control group was divided into exclusive breastfeeding group and non-exclusive breastfeeding group,and the differences in the appearance of skin symptoms,the time of hematochezia and the increase in eosinophil count were compared.According to different treatment measures,the cases were divided into the mother’s diet avoidance group and the special formula milk powder group,and the remission time of hematochezia and the treatment prognosis were compared.Use Excel and SPSS 19.0 statistical software for data sorting and analysis,P<0.05 indicates that the difference is statistically significant.Results:General information:The minimum age of onset of CMPA infants with hematochezia as the main symptom is 10 days,and the oldest age is 6 months;88.9%the mothers of 45 infants have anxiety symptoms,of which 72.5%of those with moderate to severe anxiety symptoms.The misdiagnosis rate of the case group was 28.9%,and the misuse rate of antibiotics among the misdiagnosed cases was 84.6%;The results of multivariate logistic regression showed that the high-risk factors associated with CMPA were:have a family history of allergies(with no family history of allergies as control,OR=8.128,95%CI:2.658-24.849),cesarean section(use normal delivery as control,OR=5.925,95%CI:1.648-21.304),use of formula milk within 3 days after birth(take no formula milk within 3 days after birth as a control,OR=10.734,95%CI:2.193～52.528),weight gain during pregnancy(OR=1.166,95%CI:1.021～1.322).In the study group,84.4%of infants had an increase in eosinophil count and percentage.Some infants(50.0%)underwent a second routine blood test,and both eosinophil count and percentage dropped to normal.The study groups were grouped according to different feeding methods.The time of hematochezia in the exclusive breastfeeding group was significantly later than that of the non-exclusive breastfeeding group(Z=-2.589,P<0.05).The study groups were grouped according to different treatment measures,and the CMPA symptoms in the special formula milk powder group were relieved faster than the mother avoids milk protein group(Z=-2.453,P<0.05).All CMPA infants’ physical growth and development and social life assessment results were normal during the follow-up period.Conclusions:CMPA in infants can be onset in the neonatal period;Exclusive breastfeeding can reduce the incidence of infant allergies;70%of nearly 90%of mothers have moderate-severe anxiety symptoms.The high risk factors for infant allergies are have a family allergy history,cesarean section,use of formula within 3 days after birth,and significant weight gain during pregnancy;Increased absolute count and percentage of eosinophils in blood routine of infant with clinically suspected CMPA,can assist in diagnosing CMPA;the application of special formula milk powder and changes in the mother’s diet affect the child The improvement of hematochezia symptoms has obvious effects;The results of the physical growth and development and social life assessment of infants with CMPA in this study were normal during the follow-up period.This result still needs to be verified by expanding the number of cases and in-depth research on severe cases.