关键词: 钙卫蛋白, 牛奶蛋白过敏, 过敏性肠炎, 婴儿

Abstract:

Objective: To explore the diagnostic significance of fecal calprotectin detection in infants with milk protein-allergic enteritis, and to provide valuable clinical basis for the early diagnosis and treatment decision-making of infants with milk protein-allergic enteritis. Methods: A retrospective analysis was conducted on the clinical data of 87 infants with suspected milk protein-allergic enteritis admitted in Hangzhou Children's Hospital from January 2020 to January 2023, and 38 infants with confirmed milk protein-allergic enteritis were assigned to group A, 49 infants with non-milk protein-allergic enteritis were assigned to group B, and 73 healthy infants who underwent physical examinations in Hangzhou Children's Hospital during the same period were assigned to the group C. General data of the three groups were collected through questionnaires, and fecal specimens were collected to detect the level of fecal calprotectin. The area under receiver operating characteristic (ROC)curve (AUC)was used to analyze the diagnostic value of fecal calprotectin for allergic enteritis and milk protein-allergic enteritis. The correlation between eosinophilic granulocytes (EOS)and platelets (PLT)levels and fecal calprotectin levels was analyzed by Pearson method. Results: The levels of EOS in groups A, B and C were (0.73±0.21)×10⁹/L, (0.41±0.10)×10⁹ /L, (0.26±0.05)×10⁹ /L respectively, the levels of PLT were (381.03±46.04)×10⁹ /L, (336.98±52.57)×10⁹ /L, (300.22±23.00)×10⁹ /L respectively, and the levels of EOS, PLT in group A were higher than those in group B and group C (P < 0.05), and those in group B were higher than those in group C (P < 0.05). The levels of fecal calprotectin in groups A, B and C were (324.45±174.56) μg/g, (196.12±83.39) μg/g, (143.73±50.54) μg/g respectively, and the levels of fecal calprotectin in group A were higher than those in group B and group C (P < 0.05), and those in group B were higher than those in group C (P < 0.05). The AUC values of fecal calprotectin and milk protein in the diagnosis of allergic enteritis were 0.758 and 0.792, respectively, the sensitivities were 0.575 and 0.711 respectively, the specificities were 0.904 and 0.861 respectively, the optimal cut-off values were 202.500 and 235.000 respectively, and the 95%CI were 0.683-0.833 and 0.688-0.896 respectively. The level of EOS was positively correlated with the level of fecal calprotectin (r=0.325, P < 0.05), and the PLT level was positively correlated with the level of fecal calprotectin (r=0.280, P < 0.05). Conclusion: Fecal calprotectin may have high clinical significance in infants with milk protein-allergic enteritis, and EOS and PLT levels may be positively correlated with the levels of fecal calprotectin. The higher the fecal calprotectin level, the more serious the inflammatory response.

Key words: Calprotectin, Milk protein allergy, Enteritis anaphylactica, Infant