《中国婴儿轻中度非IgE介导的牛奶蛋白过敏诊断和营养干预指南》要点解读

doi:10.3969/j.issn.1006-5725.2025.24.001

Abstract

Abstract:

Cow’s milk protein allergy （CMPA） is an abnormal immune response triggered by cow′s milk proteins. Clinically， CMPA can be categorized into immediate-onset IgE-mediated， delayed-onset non-IgE-mediated， or mixed forms. Although several expert consensus statements on CMPA have been published in China， they often fail to clearly differentiate between IgE-mediated and non-IgE-mediated subtypes. Non-IgE-mediated CMPA is more prevalent in infants； however， due to the absence of specific clinical manifestations and standardized diagnostic approaches， its diagnosis and management remain significant clinical challenges. To facilitate the standardized diagnosis and management of non-IgE-mediated CMPA in infants， a multidisciplinary panel of experts convened by the Allergy Prevention and Control Professional Committee of the Chinese Preventive Medicine Association has developed the “Guidelines for Diagnosis and Nutritional Intervention of Mild to Moderate Non-IgE-Mediated Cow′s Milk Protein Allergy in Chinese Infants.” This article presents and interprets the key recommendations of the guideline， focusing on clinical features， diagnostic procedures， nutritional management， and complementary feeding strategies for infants with mild to moderate non-IgE-mediated CMPA.

Key words: cow′s milk protein allergy, infant, non-IgE mediated, diagnostic process, nutritional management

CLC Number:

R723

Huanxiang PANG,Zhen ZHOU,Ying LIN,Yanfang TAN,Jie GAO,Yuzhen ZHANG,Wangkai. LIU. Interpretation of 《Guidelines for diagnosis and nutritional intervention of mild to modetate non⁃IgE mediated cow′s milk protein allergy in Chinese infants》[J]. The Journal of Practical Medicine, 2025, 41(24): 3793-3801.

Figures/Tables 2

References 55

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维度	传统实践	2022指南推荐	推荐价值
疾病分型	未明确区分IgE介导与非IgE介导的CMPA，混合处理。	首次针对非IgE介导这一免疫类型制定独立指南。	实现精准医疗，解决该类疾病诊断和管理上的难题。
诊断金标准	依赖单一症状或不确定的实验室指标，标准不统一。	明确“EDA?OFC”为唯一可靠诊断方法。	提供客观、可操作性的路径，减少误诊和漏诊。
实验室检测	常误用皮肤点刺试验或血清slgE检测进行诊断。	明确指出血清slgE检测和皮肤点刺试验对non-IgE-CMPA不具有诊断参考价值。	纠正临床常见误区，避免诊断错误与不必要的医疗成本。
评估工具	缺乏针对non-IgE-CMPA的特异性评估工具。	推出改良non-IgE-CMPA与婴儿功能性胃肠病相关性评分量表	为与婴儿功能性胃肠病的鉴别诊断提供量化、客观的评估工具。

Interpretation of 《Guidelines for diagnosis and nutritional intervention of mild to modetate non⁃IgE mediated cow′s milk protein allergy in Chinese infants》

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