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

孙欢; 李禄全; 包蕾

doi:10.16016/j.1000-5404.202004299

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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

临床医学 | 更新时间：2026-01-09

- 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
- Comparison of clinical characteristics of neonatal necrotizing enterocolitis and food protein-induced proctocolitis in neonates with bloody stool as the initial symptoms
- 第三军医大学学报 2020年42卷第20期页码：2063-2068
- 作者机构：
  
  400014 重庆，重庆医科大学附属儿童医院新生儿诊治中心，国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室
- 作者简介：
  
  [包蕾，E-mail: 1021004676@qq.com BAO Lei, E-mail: 1021004676@qq.com
- 基金信息：
  
  重庆市社会事业与民生保障科技创新专项(CSTC2018jscx-msybX0027)
- DOI：10.16016/j.1000-5404.202004299
  中图分类号： R441.6;R725.462;R725.931
- 收稿：2020-04-28，
  
  修回：2020-07-24，
  
  纸质出版：2020-10-30
- 稿件说明：
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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.

Huan SUN, Luquan LI, Lei BAO. Comparison of clinical characteristics of neonatal necrotizing enterocolitis and food protein-induced proctocolitis in neonates with bloody stool as the initial symptoms[J]. Journal of Third Military Medical University, 2020, 42(20): 2063-2068.
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. DOI： 10.16016/j.1000-5404.202004299.

Huan SUN, Luquan LI, Lei BAO. Comparison of clinical characteristics of neonatal necrotizing enterocolitis and food protein-induced proctocolitis in neonates with bloody stool as the initial symptoms[J]. Journal of Third Military Medical University, 2020, 42(20): 2063-2068. DOI： 10.16016/j.1000-5404.202004299.

摘要

目的

分析以血便为首发表现收治入院的新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis

NEC)与食物蛋白过敏性直肠结肠炎(food protein-induced proctocolitis

FPIPC)的临床特征。

方法

回顾性分析2018年本院门诊中收治的207例以血便为首发症状的NEC及FPIPC患儿的临床资料，其中FPIPC 150例(72.5%)，NEC 57例(27.5%)。比较两组的临床症状、实验室指标、影像学结果、治疗及预后。

结果

FPIPC组患儿较NEC组更易腹泻，粪便中更易出现脂肪球，外周血嗜酸性粒细胞升高更明显(

0.05)；NEC组患儿较FPIPC组发病更早，更易出现腹胀、呕吐、发热，C反应蛋白升高，粪便中出现白细胞，肠壁积气或门脉积气(

0.05)。

结论

以血便为首发表现的患儿中，NEC发病年龄更早，更易合并败血症。FPIPC患儿血嗜酸性粒细胞增高更明显，亦可出现肠壁积气及门脉积气。

Abstract

Objective

To analyze the clinical characteristics of neonatal necrotizing enterocolitis (NEC) and food protein-induced proctocolitis (FPIPC) in neonates with bloody stool as the initial manifestation.

Methods

We retrospectively analyzed the clinical data of 207 neonates with NEC (

=57; 27.5%) and FPIPC (

=150; 72.5%)

who presented with bloody stool as the initial symptom and were treated in the outpatient clinic of our hospital between January 2018 and December 2018. The clinical symptoms and signs

laboratory test results

imaging findings

treatment and prognosis were compared between the two groups.

Results

The neonates with FPIPC were more likely to have such clinical manifestations as diarrhea

fat globules in the feces and e

levated peripheral blood eosinophil count than those with NEC (

0.05). The neonates with NEC often had disease onset at a younger age and were more likely to have abdominal distension

vomiting

fever

elevated C-reactive protein

white blood cells in the feces

pneumatosis intestinalis

and portal venous gas than those with FPIPC group (

0.05).

Conclusion

In neonates admitted for bloody stool as the initial symptom

NEC often occurs at a younger age than FPIPC and is associated with a higher incidence of sepsis. The neonates with FPIPC often have more obvious elevation of eosinophil count

which can be accompanied by pneumatosis intestinalis or portal gas accumulation.

关键词

Keywords

references

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