目的 探究二甲双胍在多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者中的促排卵效果。方法 选取2019年1月—2020年12月收治的66例PCOS患者进行回顾性分析,以治疗方案为依据进行分组(对照组、观察组),对照组均采用炔雌醇环丙孕酮进行治疗(n=33),观察组则在其基础上联合二甲双胍进行治疗(n=33),对比两组患者的性激素水平[黄体酮生成素(luteinizing hormone,LH)、睾酮(testosterone,T)]、血糖指标[空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数]及促排卵效果。结果 观察组在治疗后的LH、T水平均低于对照组(P＜0.05);且观察组在治疗后的FPG、FINS、胰岛素抵抗指数水平均低于对照组(P＜0.05);此外,经过治疗后,观察组患者的排卵率为54.5%,高于对照组的30.3%(P＜0.05)。结论 将二甲双胍应用于PCOS患者的治疗方案中,可显著改善其性激素水平及血糖代谢情况,促进排卵率的提升,在PCOS导致的不孕症治疗中具有积极的应用价值。

Objective To explore the effect of metformin on ovulation induction in patients with polycystic ovarian syndrome (PCOS). Methods A total of 66 cases of PCOS patients from January 2019 to December 2020 were retrospectively analyzed and divided into control group and observation group according to the treatment plan. The control group was treated with ethinylestradiol and cyproterone (n=33), while the observation group was treated with metformin additionally (n=33). The levels of sex hormone (luteinizing hormone,testosterone),the indexes of fasting plasma glucose (FPG), fasting insulin (FINS) and homeostasis model assessment for insulin resistance (HOMA-IR) in the two groups were compared. The effects of ovulation induction were evaluated. Results The hormone levels of the observation group after treatment were lower than those of the control group (P<0.05); and the FPG, FINS and HOMA-IR levels of the observation group after treatment were lower than those of the control group (P<0.05); in addition,the ovulation rate of the observation group was 54.5% after treatment, which was higher than that of the control group (30.3%, P<0.05). Conclusion Metformin in the treatment of PCOS patients could greatly improve their sex hormone levels and blood glucose metabolism, promote ovulation rate, and has application value in the treatment of infertility caused by PCOS.

目的 分析口腔种植修复和常规修复在牙列缺损治疗中的有效性。方法 选定本院2019年1月—2020年12月接诊的120例牙列缺损患者,根据修复治疗方法的不同分组,参照组60例患者采取常规修复治疗,实验组60例患者采取口腔种植修复,比较两组临床疗效、龈沟炎症因子水平、并发症发生率、满意度评分。结果 实验组临床总有效率(96.67%)高于参照组(78.33%),实验组治疗后龈沟TNF-α、IL-8、IL-6因子均低于参照组,实验组并发症发生率(1.67%)低于参照组(13.33%),实验组患者满意度评分均高于参照组,差异均有统计学意义(P＜0.05)。结论 口腔种植修复可有效改善牙列缺损患者语言、咀嚼功能,减轻龈沟炎症反应,减少并发症,提高患者满意度。

Objective To analyze the efficacy of dental implant and conventional repair in the treatment of dentition defects. Methods A total of 120 patients with dentition defects in our hospital from January 2019 to December 2020 were selected and divided into two groups according to different treatment methods. Sixty patients in the control group were treated with conventional repair, and 60 patients in the experimental group were treated with dental implant repair. The clinical efficacy, gingival crevicular inflammatory factors level, complication incidence and satisfaction score of the two groups were compared. Results The clinical efficacy of the experimental group (96.67%) was higher than that of the control group (78.33%), the levels of TNF-α, IL-8 and IL-6 in the gingival sulcus of the experimental group were lower than those of the control group after treatment, the complications incidence of the experimental group (1.67%) was lower than that of the control group (13.33%), and the satisfaction score of the experimental group was higher than that of the control group, the differences were statistically significant (P＜0.05). Conclusion Dental implant repair could effectively improve the language and chewing function of patients with dentition defects, reduce gingival crevicular inflammatory reaction, complications and improve patients' satisfaction.

目的 探讨个体化低速率对比剂注射方案联合低管电压扫描在低体质量指数(body mass index,BMI)受检者头颈部CT血管成像的可行性。方法 选取我科2020年1月—2020年11月低BMI受检者头颈部CTA检查90例进行研究,随机分成三组,每组30例。A组80 kV扫描,低流速、低总量注射方案; B组120 kV扫描,高流速、低总量注射方案;C组为120kV扫描条件,高流速、高总量注射方案。对比各组注射流速、注射总量、辐射剂量长度乘积(dose legth product,DLP),评价各组图像的主动脉弓、颈总动脉、基底动脉、胸锁乳突肌中段的CT值、信噪比及对比信噪比,由两名有经验的放射科医生对各组图像质量进行主观评价。结果 图像质量主观评价A、B两组图像评分集中在4分段,C组图像评分集中在3分段,A、B组与C组主观评分比较差异有统计学意义(P<0.05)。A组对比剂注射流速和DLP比B、C组分别下降27.75%、47.10%;A、B组对比剂注射总量较C组下降39.87%,差异有统计学意义(P<0.05)。A组各血管CT值对应比B、C组数值稍高,除主动脉弓CT值外其余血管客观参数对比均有差异(P<0.05)。结论 低BMI受检者头颈部CT血管个体化低流速精准对比剂注射方案联合低管电压扫描技术在获得满足诊断要求图像质量的前提下,既能降低受检者对比剂注射速率和注射风险,又能降低辐射剂量,值得推广应用。

Objective To explore the feasibility of individualized low rate contrast agent injection scheme combined with low tube voltage scanning in CTA imaging of low body mass index(BMI) subjects' head and neck. Methods Ninety cases of head and neck CTA examination of low BMI subjects in our department from January 2020 to November 2020 were selected for the study, and randomly divided into three groups with 30 cases in each group. Group A applied 80 kV scanning, low flow rate and low total volume injection scheme. Group B applied 120 kV scanning, high flow rate, low total volume injection scheme. Group C applied 120 kV scanning, high flow rate and high total volume injection scheme. The injection velocity, injection volume, radiation dose length product (DLP) among three groups were compared. In each image of the aortic arch, common carotid artery, basilar artery and the central part of sternocleidomastoid, the CT value, the signal-to-noise ratio and contrast-to-noise ratio were evaluated. Two experienced radiologists performed image quality evaluation. Results Image quality in group A and B by subjective evaluation got 4 points out of 4, and group C got 3 points out of 4, and there was statistical difference between group A, B and C in subjective evaluation of image quality (P<0.05). The injection velocity and DLP of contrast agent in group A were 27.75% and 47.10% lower than those in group B and C, respectively. The total amount of contrast agent injection in groups A and B was decreased by 39.87% compared with group C, with statistical difference (P<0.05). The corresponding CT values of each vessel in group A were slightly higher than those in group B and C, and there were statistically significant differences in the Objective parameters of other vessels except for aortic arch (P<0.05). Conclusion The combination of individualized low flow rate and precise contrast agent injection scheme with low tube voltage scanning technology for low BMI subject could not only reduce the injection rate and risk of contrast agent, but also reduce radiation dose, on the premise of meeting the diagnostic requirements of image quality. It is worthy of popularization and application.

目的 回顾性分析因化疗需要行完全植入式输液港的乳腺癌患者相关血栓形成的因素。方法 收集广州市第一人民医院乳腺外科2018年5月—2019年4月期间行植入式输液港置入术的60例乳腺癌患者相关资料,采用SPSS 26.0软件进行统计学分析。结果 输液港相关血栓形成(catheter related thrombosis,CRT)发生率为21/60(35%)。BMI≤24的患者CRT发生率为30.3%,BMI＞24则为40.74%;行4、6、8次化疗的CRT发生率分别为20%、33.34%、44.12%,导管末端位于T5-T8的CRT发生分别为:66.67%, 26.09%, 28.57%, 50%;Ki-67高表达的血栓发生率为27.5%,低Ki-67表达则为50%;导管材质为聚氨酯的血栓发生率为47.62%,硅胶材质则为28.21%,但差异均无统计学意义(P＞0.05)。雌激素受体/孕激素受体(estragen receptor/progesterone receptor,ER/PR)阴性的CRT发生率为60%,ER/PR阳性则为23.8%(P＜0.05);人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)阳性CRT发生率为50%,HER-2阴性CRT发生率则为23.53%(P＜0.05)。多因素分析:相对于ER/PR阳性,ER/PR阴性将增加CRT的发生(OR=4.482, 95%CI:1.116～17.998, P＜0.05);Ki-67的表达对血栓形成的影响具有统计学意义(OR=7.051, 95%CI:1.513～32.858, P＜0.05);HER-2表达对CRT的形成均无统计学意义(OR=0.254,95%CI:0.058～1.115, P＞0.05)。结论 血栓形成是植入式输液港术后常见的并发症,与肿瘤ER/PR表达相关,临床上应得到重视。

Objective To analyse the factors that lead to venous thrombosis among breast cancer patients who need totally implantable access port(TIAP) for chemotherapy. Methods Collecting the clinical data of 60 breast patients admitted to Guanzhou First People's Hospital from May 2018 to April 2019, analysed with SPSS 26.0. Results Catheter-related thrombosis(CRT) occurred in 21 out of 60(35%) patients with TIAP. 30.3% patients with BMI≤24 and 40.74% patients with BMI＞24 had CRT, and incidences of CRT were 20%, 33.34%, 44.12% at the fourth, sixth, eighth therapy respectively. The access terminal position at T5-T8 had 66.67%, 26.09%, 28.57%, 50% of incidence for CRT respectively. 27.5% CRT was with high Ki-67 expression and 50% CRT was with low Ki-67 expression; 47.62% patients with polyurethane catheter and 28.21% patients with silicone catheter got CRT. There were no significant differences in the comparisons above. CRT incidence in ER/PR negative patients was 60%,while 23.08% in ER/PR positive patients (P＜0.05). In HER-2 positive and negative patients, the incidences of CRT were 50% and 23.53% (P＜0.05). Logistic regression noticed that ER/PR negative would increase the incidence of CRT(OR=4.482, 95%CI:1.116～17.998, P＜0.05), low Ki-67 expression would accelerate CRT(OR=7.051, 95%CI:1.513～32.858, P＜0.05). There was no significant difference in the formation of CRT with HER-2 expression(OR=0.254, 95%CI:0.058～1.115, P＞0.05). Conclusion CRT was a common complication of TIAP, which related with ER/PR expression, and should pay attention to during clinical practices.

目的 了解石岐区户籍居民2019年死因分布和主要死因对预期寿命的影响,为调整疾病控制战略方向提供支撑。方法 对2019年石岐区户籍居民死因数据进行基于国际通用编码ICD-10的分类,通过计算预期寿命、死亡率、去死因预期寿命变化、标准化死亡率、寿命损失率和潜在寿命损失年数对死因数据进行研究与分析。结果 石岐区户籍居民2019年粗死亡率为636.88/10万,每10万男性和女性分别平均死亡706.39人和569.86人,恶性肿瘤、心脏病、脑血管病、呼吸系统疾病和内分泌营养代谢疾病为前五位死亡原因。恶性肿瘤中肺癌、肝癌和结肠直肠肛门癌的死亡率位列前三,心脏病中缺血性心脏病死亡率最高。撇除死因的影响后,增加预期寿命的前三名分别是恶性肿瘤(4.40岁)、心脏病(2.76岁)和脑血管病(1.79岁)。2019年石岐区潜在寿命损失年数为10 001.32人年,减寿率为58.64‰,恶性肿瘤、损伤和脑血管病是潜在寿命损失年数前三位死因,减寿率分别为27.80‰、7.72‰和5.18‰。结论 恶性肿瘤、心脏病和脑血管病是石岐区户籍居民的主要死因,也是造成2019年石岐区户籍居民寿命损失的最主要疾病,并造成沉重的疾病负担,应作为今后的防控重点,政府需采用综合性的防控措施,降低慢性病的危害,保护居民健康。

Objective To analyze the distribution characteristics of death causes and influence of major death causes on life expectancy of Shiqi district in 2019, and provide support to develop strategies for disease prevention and control. Methods The 2019 death causes of residents in Shiqi district were classified by International Classification of Diseases-10 (ICD-10). The life expectancy, mortality rate, cause eliminated life expectancy, standardized mortality rate, potential years of life lost rate (PYLLR), and potential years of life lost (PYLL) were calculated. Results The mortality of residents of Shiqi district in 2019 was 636.88/10⁵. The male mortality and female mortality were 706.39/10⁵and 569.86/10⁵, respectively. The top five causes of death in Shiqi district were malignant tumors, heart diseases, cerebrovascular diseases, respiratory diseases, and endocrine nutrition and metabolic diseases. The malignant tumors with top three death rates were lung cancer, liver cancer, and colorectal and anal cancer. The highest death rate of heart disease was ischemic heart disease. The top three causes shortening life expectancy were malignant tumors(4.40 years), heart diseases(2.76 years), and cerebrovascular diseases (1.79 years). The PYLL was 10 001.32 person-year, the PYLLR was 58.64‰ in Shiqi distric,2019. The top three causes of life loss were malignant tumors, injury and cerebrovascular diseases. The PYLLR of those three death causes were 27.80‰, 7.72‰, and 5.18‰, respectively. Conclusion Malignant tumors, heart disease and cerebrovascular diseases were the main death causes and the major diseases for life lost of residents in Shiqi district, which caused heavy disease burden and should be focused in the future. For protecting the residents from the harm due to chronic non-communicable diseases, comprehensive preventive and controling measures should be taken by government.

目的 分析妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇接受胰岛素治疗对妊娠结局的影响及安全性。方法 将2018年7月—2020年7月接诊且行常规治疗的50例GDM孕妇作为对照组,将同期接诊且在对照组基础上行胰岛素治疗的50例GDM孕妇作为观察组,对组间血糖控制效果、生活质量(SF-36)、治疗效果、不良妊娠结局、不良反应展开分析。结果 (1)组间血糖指标在治疗前无明显差异(P＞0.05);治疗后,观察组血糖控制效果优于对照组(P<0.05);(2)观察组SF-36评分高于对照组,且治疗效果(96.00%)优于对照组(82.00%,P<0.05);(3)观察组出现3例不良妊娠结局(6.00%),对照组出现11例不良妊娠结局(22.00%,P<0.05);(4)观察组发生3例不良反应(6.00%),对照组发生2例不良反应(4.00%,P＞0.05)。结论 对GDM孕妇实施胰岛素治疗,可以改善孕妇血糖水平,减少不良妊娠结局,提高孕妇生活质量,安全可靠,值得推广。

Objective To analyze the effect and safety of insulin therapy on pregnancy outcome in pregnant women with gestational diabetes mellitus (GDM). Methods A total of 50 pregnant women with GDM who received conventional treatment from July 2018 to July 2020 were induded in the control group, and 50 pregnant women with GDM who received insulin treatment on the basis of the control group were induded in the observation group. Results (1) There was no significant difference in blood glucose index between two groups before treatment(P＞ 0.05); after treatment, the blood glucose control effect of the observation group was better than that of the control group(P<0.05); (2) SF-36 score of the observation group was higher than that of the control group, and the treatment effect (96.00%) was better than that of the control group (82.00%,P<0.05); (3) there were 3 cases of adverse pregnancy outcomes (6.00%) in the observation group and 11 cases (22.00%) in the control group; (4) there were 3 cases of adverse reactions (6.00%) in the observation group and 2 cases (4.00%) in the control group(P＞ 0.05). Conclusion Insulin therapy for pregnant women with GDM could improve the blood glucose level of pregnant women, reduced adverse pregnancy outcomes, improved the quality of life of pregnant women, which is safe and reliable, and is worthy of promotion.

目的 通过生物信息学方法,分析阿司匹林抗结直肠癌的作用机制。方法 在DrugBank 5.1.5中查找阿司匹林的直接作用蛋白靶点(direct protein targets,DPTs);构建阿司匹林DPTs的蛋白质-蛋白质相互作用(protein-protein interaction,PPI)网络并分析相关信号通路;从GEO数据库中获取结直肠癌表达谱芯片数据,筛选中心度最高的20个结直肠癌差异表达基因作为Hub基因;将DPTs相互关联基因与结直肠癌Hub基因求交集,确认阿司匹林抗结直肠癌的潜在作用靶点,分析其在TCGA数据库结肠腺癌样本中的表达情况,并进行GO功能富集分析和KEGG信号通路分析。最终通过RT-PCR和WB实验验证阿司匹林抗结直肠癌的潜在靶点。结果 在DrugBank 5.1.5中确定了11个阿司匹林DPTs,KEGG信号通路分析发现其中6个DPTs(EDNRA,IKBKB,NFKB2,NFKBIA,PTGS2,TP53)与癌症的发生发展有关。将DPTs相关联基因与筛选的20个结直肠癌Hub基因求交集,发现5个基因(CDK1,AURKA,CCNB1,MAD2L1,TPX2)可能是阿司匹林抗结直肠癌的潜在作用靶点,其在TCGA数据库结肠腺癌样本中均表达上调,基因功能主要富集于细胞周期调控。RT-PCR和WB实验结果显示阿司匹林可以降低人结肠癌细胞中CDK1,AURKA,CCNB1,MAD2L1,TPX2的mRNA水平和蛋白表达。结论 CDK1,AURKA,CCNB1,MAD2L1,TPX2可能是阿司匹林抗结直肠癌的潜在靶点,其可能通过影响细胞周期调控发挥抗肿瘤作用。

Objective To analyze the mechanism of aspirin against colorectal cancer(CRC)by bioinformatic analysis. Methods DrugBank 5.1.5 was used to identify direct protein targets (DPTs) of aspirin. The protein-protein interaction (PPI) network of DPTs was constructed and involved signaling pathways were analyzed. CRC-associated gene expression datasets were downloaded from GEO database, and the top twenty differentially expressed genes with the highest degree were screened out as Hub genes. Common genes between the genes associated with the DPTs and the Hub genes of CRC were the potential targets of aspirin against CRC. The potential targets in TCGA database colon adenocarcinoma (COAD) samples were examined. GO functional enrichment analysis and KEGG signaling pathway analysis of the potential targets were performed. The potential targets of aspirin against CRC cells were verified by reverse transcription-polymerase chain reaction (RT-PCR) and western blot (WB). Results Eleven DPTs of aspirin were identified in DrugBank 5.1.5. KEGG signaling pathway showed that 6 genes (EDNRA, IKBKB, NFKB2, NFKBIA, PTGS2, TP53) were associated with the occurrence and development of CRC. By intersecting 20 Hub genes of CRC with genes associated with the DPTs of aspirin, it was found that 5 genes (CDK1, AURKA, CCNB1, MAD2L1, TPX2) might be the potential targets of aspirin against CRC. They were all up-regulated in TCGA-COAD samples, and the gene functions were mainly enriched in cell cycle regulation. The results of RT-PCR and WB showed that aspirin could down-regulate the mRNA and protein expression levels of CDK1, AURKA, CCNB1, MAD2L1 and TPX2 in human colon cancer cells respectively. Conclusion CDK1, AURKA, CCNB1, MAD2L1 and TPX2 could be potential targets of aspirin against CRC by affecting the progress of cell cycle regulation.

目的 探究硼替佐米、地塞米松联合环磷酰胺治疗骨髓瘤的疗效及对患者不良反应发生的影响。方法 研究对象为我院2016年1月—2020年12月收治的60例骨髓瘤患者,将其随机分为研究1组(n=20)、研究2组(n=20)与对照组(n=20)。对照组给予硼替佐米联合沙利度胺及地塞米松化疗,研究1组给予硼替佐米联合环磷酰胺及地塞米松化疗,研究2组给予硼替佐米联合来那度胺及地塞米松化疗。对比三组治疗效果、免疫功能变化情况、相关血清因子水平以及骨代谢因子水平变化情况。结果 对照组治疗有效率85.0%比研究1组95.0%、研究2组90.0%低(P＜0.05);三组治疗前的免疫对比无较大差异(P＞0.05),对照组经治疗后的免疫功能比研究组差(P＜0.05);三组治疗前的相关血清因子水平比较无较大差异(P＞0.05),对照组经治疗后的相关血清因子水平比研究1组、研究2组高(P＜0.05);对照组经治疗后的骨代谢因子水平变化比研究1组、研究2组差(P＜0.05)。结论 硼替佐米、地塞米松联合环磷酰胺治疗骨髓瘤效果理想,药物不良反应发生率下降,患者生活质量得到改善,可在临床推广应用。

Objective To investigate the clinical efficacy of bortezomib,dexamethasone combined with cyclophosphamide in the treatment of myeloma and the effect on the occurrence of adverse reactions in patients. Methods The subjects were 60 myeloma patients admitted to our hospital from January 2016 to December 2020, and they were randomly divided into study group 1 (n=20), study group 2 (n=20) and control group (n=20). The control group received bortezomib combined with thalidomide and dexamethasone chemotherapy, the study group 1 received bortezomib combined with cyclophosphamide and dexamethasone chemotherapy, and the study group 2 received bortezomib combined with lenalidomide and dexamethasone chemotherapy. The therapeutic efficacy, the changes of immune function,serum factors and bone metabolism factors were compared among the three groups. Results The effective rate of control group was 85.0%, which was lower than those of study group 1 and study group 2 (P＜0.05). There was no significant difference of immune function among the three groups before treatment (P＞0.05), which of the control group after treatment was worse than that of the study groups (P＜0.05). There were no significant differences in the levels of related serum factors among the three groups before treatment (P＞0.05),which in the control group after treatment was higher than those in the study group 1 and study group 2 (P＜0.05). After treatment, the changes of bone metabolic factors in control group were worse than those in study group 1 and study group 2 (P＜0.05). Conclusion Bortezomib, dexamethasone combined with cyclophosphamide in the treatment of myeloma had ideal effect, and the incidence of adverse drug reaction was reduced, the quality of life of patients was improved, which can be popularized in clinical application.

目的 探讨大黄穴位贴联合直肠指力刺激在脑卒中后便秘患者的应用效果。方法 本研究选择2019年1月—2019年12月间我院收治的脑卒中后便秘患者90例,随机分成A组(大黄穴位贴组),B组(直肠指力刺激组),C组(大黄穴位贴联合直肠指力刺激组)三组,每组30例。记录三组患者便秘治疗有效率,采用Wexner便秘评分系统评估三组患者治疗前后的便秘程度并进行自身前后对比。结果 三组干预前后Wexner评分采用自身配对非参数秩和检验,差异有统计学意义(P＜0.05)。三组干预前后差值采用Kruskal-Wallis H检验结果差异有统计学意义(H=26.211,P＜0.05),经过两两对比,差异有统计学意义(P＜0.05)。值得注意的是,干预后C组Wexner评分下降。干预后C组患者的有效率高于其他两组,有效率结果为C组(90%)＞B组(80%)＞A组(53.5%),差异有统计学意义(P＜0.05)。结论 相较于单一应用大黄穴位贴或直肠指力刺激,大黄穴位贴联合直肠指力刺激治疗效果更好,可有效降低便秘发生率,提高病人生活质量。

Objective To explore the effect of rhubarb acupoint application combined with rectal finger force stimulation in patients with constipation after stroke. Methods In this study, 90 patients with post-stroke constipation admitted to our hospital from January 2019 to December 2019 were randomly divided into group A (rhubarb acupoint application group), group B (rectal finger force stimulation group) and group C (rhubarb acupoint application combined with rectal finger force stimulation group), 30 cases in each group. The effective rates of constipation treatment in the three groups were recorded, and the Wexner constipation scoring system was used to evaluate the degree of constipation before and after treatment among three groups. Results The Wexner scores of the three groups before and after treatment were analyzed by self-paired non-parametric rank sum test, and the differences were statistically significant (all P<0.05). The difference among the three groups before and after treatment using Kruskal-Wallis H test was statistically significant (H=26.211, P<0.05), and after pairwise comparison, the differences were statistically significant (P<0.05). It was worth noting that the Wexner score of group C dropped significantly after treatment. The effective rate of treatment in group C was significantly higher that those in the other two groups. The result showed effective rate of group C (90%)＞ group B (80%)＞group A (53.5%), the difference was statistically significant (P<0.05). Conclusion Compared with the single treatment of rhubarb acupoint application or rectal finger force stimulation, the combined treatment had better efficacy, which reduced incidence of constipation and improved the quality of life of patients.

目的 探讨婴儿过敏性直肠结肠炎的临床特点及肠镜、肠黏膜病理特点。方法 回顾性分析2016年1月—2018年12月我院收治的110例婴儿过敏性直肠结肠炎的临床资料及其结肠镜、肠黏膜病理结果、食物过敏原特异度IgG、血常规、粪常规、血清总IgE检测及治疗情况。结果 110例过敏性直肠结肠炎中男67例,女43例,< 6月龄98例;单纯母乳喂养26例,单纯牛奶喂养19例,混合喂养65例;临床表现均有腹泻,大部分患儿伴有血便(93例),部分患儿伴湿疹(23例)、排便哭闹(67例)、夜眠不安稳(61例)、呕吐(8例)、营养不良(6例);血嗜酸性粒细胞升高63例;血清总IgE升高21例;食物过敏原特异度IgG检测结果,牛奶103例,鸡蛋62例;内镜下病变均累及降结肠、乙状结肠、直肠,累及横结肠76例、升结肠47例、回盲部18例;最常表现为疱疹样改变(106例)、糜烂(97例)、溃疡(13例),组织病理学表现为肠黏膜嗜酸性粒细胞浸润91例,隐窝炎、隐窝增生21例,淋巴滤泡形成18例、浅表溃疡形成4例;18例经母亲规避饮食后好转,8例经先换用氨基酸奶粉喂养1周、再逐渐引入母乳后好转;19例换用深度水解或氨基酸奶粉喂养后好转;65例经换用深度水解或氨基酸配方奶粉喂养、同时母亲规避饮食后好转。结论 婴儿过敏性直肠结肠炎缺乏特异度表现,多数临床经过良好,仅少数并发营养不良;牛奶是最主要的过敏原;腹泻、便血病史、血嗜酸细胞升高、肠镜疱疹样改变、肠黏膜嗜酸细胞浸润,提示过敏性直肠结肠炎可能性大;母亲规避饮食或换用氨基酸或深度水解奶粉治疗有效,也是确诊的标准。

Objective To investigate the clinical features of infantile allergic proctocolitis and its endoscopic lesions and pathological features. Methods A retrospective analysis of 110 cases of infantile allergic proctocolitis admitted to our hospital from January 2016 to December 2018 and its colonoscopy and pathological results, food allergen-specific IgG, blood routine, fecal routine, serum total IgE detection and treatment. Results Among 110 patients with allergic proctocolitis, 67 were male and 43 were female, 98 were < 6 months old; 26 were breastfed exclusively, 19 were fed milk alone, and 65 were mixed feeding. The clinical manifestations were diarrhea, most of children with bloody stools (93 cases), some children with eczema (23 cases), defecation and crying (67 cases), restless sleep (61 cases), vomiting (8 cases), malnutrition (6 cases); blood eosinophils increased in 63 cases,serum total IgE increased in 21 cases. Food allergen-specific IgG test results:103 cases of milk, 62 cases of eggs. Endoscopic lesions involved the descending colon, sigmoid colon, rectum, 76 cases of transverse colon, 47 cases of ascending colon and 18 cases of ileocecal. Most common manifested as herpes-like changes (106 cases), erosion (97 cases), ulcers (13 cases). Histopathology showed 91 cases of intestinal mucosal eosinophil infiltration, 21 cases of cryptitis and crypt hyperplasia, 18 cases of lymphoid follicle formation and 4 cases of superficial ulcer formation. 18 cases were improved after the mother evaded diet. 8 cases were improved by feding with amino acid milk powder for one week, and then breast milk was gradually introduced; 19 cases were improved after switching to deep hydrolysis or amino acid milk powder. 65 cases were improved after switching to deep hydrolysis or amino acid milk powder and simultaneously the mother evaded diet. Conclusion Infantile allergic proctocolitis lack of insufficient specific manifestations, most of the clinical cases are good, only a few are complicated by malnutrition. Milk is the most important allergen. Diarrhea, history of blood in the stool, elevated blood eosinophils, intestinal herpes-like changes, bowel mucosal eosinophil infiltration, are suggesting a high possibility of allergic proctocolitis. Mothers avoiding diet or switching to amino acids or deep hydrolyzed milk powder treatment is also effective, and this is also the standard of diagnosis of proctocolitis.