什么时候牛奶相关症状评分 (CoMiSS) 可以成为西班牙儿科医生的有用工具?
Rafael Martín-Masot1, Juan J Díaz-Martín2, Alicia Santamaria-Orleans3
1Unidad De Gastroenterología y Nutrición Pediátrica, Hospital Regional Universitario de Málaga, Málaga, Spain.
Anales de pediatria
|November 15, 2025
概括
牛奶相关症状评分 (CoMiSS) 在诊断牛奶蛋白过敏 (CMPA) 时可能未得到充分利用. 这项研究发现,只有三分之一的婴儿在诊断时具有积极的CoMiSS得分,这表明需要更好的实施策略.
科学领域:
- 儿科 儿科 儿科
- 过敏和免疫学 过敏和免疫学
- 胃肠病学 胃肠病学
背景情况:
- 牛奶相关症状评分 (CoMiSS) 是评估婴儿牛奶蛋白过敏 (CMPA) 的临床工具.
- 准确诊断CMPA需要专家确认.
- 这项研究旨在比较IgE介导CMPA与非IgE介导CMPA的婴儿的CoMiSS得分.
研究的目的:
- 为了比较CoMiSS在被诊断为IgE介导和非IgE介导CMPA的婴儿中的有效性.
- 评估CoMiSS在评估CMPA严重程度和治疗反应方面的有用性.
主要方法:
- 这是一项多中心的,涉及西班牙294名儿科医生的横截面调查.
- 在CMPA诊断时和开始广泛化配方 (EHF) 后7天,CoMiSS应用于1176名婴儿.
- 一个CoMiSS得分为12或更高被认为是积极的.
主要成果:
- 与非IgE介导组相比,在IgE介导的CMPA组中观察到CoMiSS得分的显着较大下降 (-9.06vs-6.00).
- 哭泣和吐等特定症状在非IgE介导小组中显示出更大的减少,而在IgE介导小组中,阿托皮性湿疹,疹和呼吸道症状得到了更大的改善.
- 患有非常严重的CMPA的婴儿在治疗后的CoMiSS总得分下降幅度更大.
结论:
- 在被诊断为CMPA的婴儿中,只有三分之一的婴儿在诊断时呈现出积极的CoMiSS得分 (≥12),这表明该工具的潜在使用不足或应用不足.
- 建议制定提高儿科医生知识和利用CMPA评估的CoMiSS的策略.
- 进一步的研究可能会探索不同CMPA表型的最佳CoMiSS值.
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