目的 探讨牛奶蛋白过敏(CMPA)婴儿的气质类型、气质维度水平及相关影响因素,为CMPA婴儿早期家庭养育提供依据。方法 选取2019年1月—2020年12月福建省妇幼保健院儿保科正常体检的婴儿102例作为对照组,选取同期在过敏专科门诊就诊的4～8月龄CMPA 102例婴儿作为病例组,对婴儿进行婴儿气质量表(CITS)、牛奶相关症状评分(CoMiSS)评估及维生素D水平检测,同时对母亲进行焦虑症自评量表(SAS)评估。结果 气质类型方面,两组婴儿的气质类型构成差异有统计学意义(χ²=51.866,P<0.05),在气质维度水平除持久性和注意分散外,牛奶蛋白过敏组婴儿活动水平、节律性、趋避性、适应性、活动强度、心境和反应阈维度得分均高于对照组(t=5.713、4.154、4.844、5.052、5.067、4.138、4.787,P<0.05);CMPA组婴儿中CoMiSS评分、母亲SAS评分均高于对照组(t=49.433、16.562,P<0.05);CMPA组婴儿维生素D水平低于对照组(t=-16.981,P<0.05)。Spearman分析显示, CMPA组婴儿母亲的焦虑情绪、CoMiSS评分与婴儿的气质类型显著相关(r=0.191、0.228,P<0.05),同时母亲的焦虑情绪水平与CoMiSS评分呈正相关、与维生素D水平呈负相关(r=0.762、-0.520,P<0.05)。结论 CMPA婴儿的气质类型存在难养型增加,易养型减少,应针对此类婴儿气质类型指导家庭养育,关注此类婴儿母亲的焦虑情绪对婴儿气质和家庭养育的影响,通过健康教育和规范诊疗,缓解婴儿过敏症状并改善营养状况,从而提高CMPA婴儿的健康水平。

Objective To explore the temperament type, temperament dimension levels and influencing factors of infants with cow's milk protein allergy (CMPA), so as to provide basis for early family nurturing of infants with CMPA. Methods From January 2019 to December 2020, 102 infants who took typical physical examination in the Child Health Center ofFujiar Provincial Maternity and Children's Hospital were enrolled as the control group, and 102 infants with CMPA aged 4 to 8 months in the allergy specialist clinic were enrolled as the case group. All infants were evaluated by Chinese Infant Temperament Scale (CITS) and Cow's Milk-related Symptom Score (CoMiSS). Vitamin D level was measured in all infants and maternal anxiety was measured using the Self-Rating Anxiety Scale (SAS). Results A significant difference was found in infants' temperament types between the two groups (χ²=51.866, P<0.05). Except persistence and distractibility at the temperament dimension, the scores of activity level, rhythmicity, approach-withdrawal, adaptability, intensity of reaction, mood and threshold of responsiveness of infants in CMPA group were higher than those in control group (t=5.713,4.154,4.844,5.052,5.067,4.138,4.787,P<0.05). The CoMiSS scores of the infants and the maternal SAS scores in the CMPA group were significantly higher than those in the control group (t=49.433, 16.562, P<0.05), while vitamin D level of infants in CMPA group was significantly lower (t＝-16.981, P<0.05). Spearman analysis showed that maternal anxiety and CoMiSS score were correlated with temperament type of infants with CMPA (r=0.191,0.228,P<0.05), and the maternal anxiety level was related to the CoMiSS score and vitamin D level (r=0.762,-0.520,P<0.05). Conclusions The temperament type of CMPA infants has increased in the difficult-to-nurture type and decreased in the easy-to-nurture type. Family parenting should be guided according to the temperament type of the infants, paying attention to the influence of maternal anxiety on the infants' temperament type and family parenting. Moreover, providing health education and standardized diagnosis and treatment can alleviate allergic symptoms and improve nutritional status of infants, thereby improving the health of infants with CMPA.