目的　评价牛奶相关症状评分（CoMiSS）在早期识别婴儿牛奶蛋白过敏（CMPA）中的作用。方法　2016年6 月至2017年5月对6家儿科门诊疑似CMPA的210例婴儿进行CoMiSS评分，通过开放性食物激发试验（OFC）明确或排除 CMPA诊断。同期选取96例健康体检婴儿为对照组。通过ROC曲线评估CoMiSS识别CMPA的灵敏度和特异度，评价其在 早期识别婴儿CMPA中的作用。结果　210例疑似CMPA婴儿中，男114例、女96例，中位年龄4.5个月（1~12个月）；其中 82例确诊CMPA，中位CoMiSS为7.0分（6.0~8.3分）；128例非CMPA婴儿的中位CoMiSS为4.0分（3.0~5.0分）。96例对 照组中，男42例、女54例，中位年龄4.1个月（1~12个月）；中位CoMiSS为 3.0分（2.0~4.0分）。 三组间CoMiSS差异有统 计学意义（H=152.58， P<0.01）。CoMiSS的ROC曲线下面积（AUC）为0.90，最佳诊断界值为5.5，灵敏度为87.8%，特异 度为78.1%。结论　CoMiSS评分临床可操作性强，适合儿科推广。建议以CoMiSS≥6分作为早期识别CMPA标准。

Objective　To explore the prevalence of cow’s milk allergy in infants in Shenzhen, China and to evaluate Cow’s milk-related Symptom Scores (CoMiSS) in predicting cow’s milk protein allergy (CMPA) in infants. Methods　A total of 210 infants with suspected CMPA (114 boys and 96 girls) with median age of 4.5 months old (1-12 months) from 6 hospitals including two municipal hospitals and four district hospitals were enrolled to calculate CoMiSS and eliminate food during June 2016 to May 2017. The 210 infants were diagnosed as CMPA or exclude CMPA by oral food challenge (OFC) test. Sensitivity and specificity of CoMiSS by ROC curve were determined, and CoMiSS in predicting CMPA in infants was evaluated as well. Results　The median CoMiSS were 7.0 (6.0~8.3), 4.0 (3.0~5.0) and 3.0 (2.0~4.0) in CMPA group, non-CMPA group and control, respectively, which showed significant differences among three groups（H=152.58, P<0.01）. Calculated by ROC curve, the area under curve of ROC was 0.90. The cut-off was 5.5. The sensitivity of CoMiSS was 87.8%, while its specificity was 78.1%. Conclusion　CoMiSS is an easy, safe tool to predict CMPA which is suitable for application in pediatric clinic and digestive clinic. It needs more multi-center studies to evaluate the criterion of integral CoMiSS≥6 in recognition of CMPA or add some scores of bloody stool.