婴儿食物过敏致上消化道出血35例分析

目的　研究婴儿食物过敏致上消化道出血的临床表现、内镜下特点及组织病理学改变，以提高婴儿食物过敏致上消化道出血的诊断水平。方法　以江西省儿童医院2006年6月至2010年7月住院的35例食物过敏致上消化道出血患儿为研究对象，回顾分析婴儿食物过敏致上消化道出血的临床表现、内镜下特点及组织病理学改变。结果　所有患儿均有呕血和轻度-中度贫血，其中嗜酸性粒细胞升高19例，轻度低蛋白血症6例，血清IgE升高20例，血清幽门螺杆菌抗体检测阳性2例；所有患儿血小板计数均正常，肝功能及凝血象检查均正常；3例患儿行血清学食物过敏原特异性IgG抗体测定，其中2例牛奶喂养患儿对牛奶高度敏感，1例母乳喂养患儿对蛋清和（或）蛋黄高度敏感。35例患儿均呈现镜下糜烂性胃炎，且为多发性病灶，其中21例患儿病变以胃底、胃体黏膜多发糜烂为主，14例为胃体、胃窦黏膜多发性糜烂，3例伴胃窦、幽门管水肿，1例食管炎。所有患儿组织病理提示胃黏膜有嗜酸性粒细胞浸润，且均经患儿和母亲食物回避治疗有效。结论　婴儿食物过敏致上消化道出血的临床症状无特异性，以牛奶喂养多见，消化道出血是常见的表现之一，内镜下表现以胃黏膜糜烂为主，饮食回避是主要的诊断及治疗方法，且疗效肯定；胃黏膜病理学检查及结合嗜酸性粒细胞计数有助于诊断。

The microecological evaluation of vaginal microflora in the women of serious vulvovaginal candidiasis.

Objective To investigate the microecological evaluation of vaginal microflora in the women of SVVC. Methods 150 women of SVVC were studied by collecting vaginal secretion, and the vagina pH and microecological evaluation based on Gram stained smear were tested. Results (1)74 % of advantage microflora were lactobacillus, and 80.67 % of the degree of microflora intensive of cases were Ⅱ ～ Ⅲ, 76% of the degree of microflora diversity wereⅡ ～ Ⅲ.(2) There were 60 cases of cleanness Ⅰ(40%), 53 cases of cleanness Ⅱ(35.33%), 37 cases of cleanness Ⅲ(24.67%).(3)About 68% of them pH was <4.5. Conclusion SVVC exist a certain degree disorder of vaginal microecosystem, the advantage microflora still are lactobacillus, the degree of microflora intensive and the degree of microflora diversity of the mainly patients are in normal range.