#常观世音微语录#
ABSTRACT
Twenty-seven consecutive infants (mean age, 20.6 months) with chronic “idiopathic” constipation were studied to investigate the possible relation between constipation and cow milk protein allergy (CMPA). The infants were initially observed on an unrestricted diet, and the number of stools per day was recorded. Subsequently the infants were put on a diet free of cow milk protein (CMP) for two periods of I month each, separated by two challenges with CMP. During the CMP-free diet, there was a resolution of symptoms in 21 patients; during the two consecutive challenges, constipation reappeared within 48 to 72 hours. In another six patients the CMP-free diet did not lead to improvement of constipation. Only four of the patients who improved on the CMP-free diet had concomitant symptoms of suspected CMPA, but a medical history of CMPA was found in 15 of the 21 patients cured and in only one of the six patients whose condition had not improved (p <0.05); in addition, in 15 of the 21 cured patients, results of one or more laboratory tests (specific IgE, IgG, anti-beta-lactoglobulin, circulating eosinophils) were positive at the time of diagnosis, indicating hypersensitivity, compared with one of the six patients whose condition did not improve (p<0.05). The endoscopic and histologic findings at the time of diagnosis showed proctitis with monocytic infiltration in two patients cured with the CMP-free diet; after I month on this diet, they were completely normal. We conclude that constipation in infants may have an allergic pathogenesis. (J PEDIATR 1995；126:34-9)
《儿科杂志》1995年1月，126卷第1期
【标题】慢性便秘是牛奶过敏的症状之一
【作者】G.Lacono, MD，A.Carrocio, MD，F.Cavatio, MD，G.Montalto, MD， M.D.Cantarero, MD and A.Notarbartolo, MD
来自哥伦比亚巴勒莫奥斯培代尔大学儿科医学研究所 克里斯蒂娜,巴勒莫,意大利
【摘要】
通过对27名(平均年龄20.6个月)患有慢性“特发性”便秘的婴儿进行研究，调查便秘与牛奶蛋白过敏(CMPA)之间存在的可能关系。首先，在饮食不受限制的条件下观察这些婴儿，并记录他们每天的大便次数。随后，喂食这些婴儿不含牛奶蛋白(CMP)的饮食两个周期，每期1个月，周期划分是根据牛奶蛋白过敏的两个挑战。在无CMP饮食期间，有21名患者的症状得到缓解；在两个连续挑战中（再次喂食牛奶），便秘在48到72小时内再次出现。另外6名患者的无CMP饮食没有导致便秘的改善。在无CMP饮食改善的患者中，仅有4例患者伴有疑似CMPA症状，然而在21例治愈患者中有15例有CMPA病史，6例病情未改善患者（P<0.05）中仅有1例有CMPA病史；此外，21例治愈患者中有15例在诊断时，特异性IgE（免疫球蛋白E）、IgG（免疫球蛋白G）、乳球蛋白抗体、循环嗜酸性粒细胞等一项或多项实验室检测结果为阳性，表明过敏，而6例病情没有好转的患者中（P<0.05）有1例检测出这样的结果。诊断时的内窥镜和组织学检查结果显示，两名患有单核细胞浸润性直肠炎的患者在无CMP饮食治疗后治愈；1个月后，他们完全正常。我们推断婴儿便秘可能有过敏发病机制。