炎症性肠病初诊患儿营养状况及影响因素分析

Nutritional status and its influencing factors in children with newly diagnosed inflammatory bowel disease

目的探讨初诊炎症性肠病(inflammatory bowel disease,IBD)患儿的营养状况及其影响因素。方法对2015年1月—2021年12月于湖南省儿童医院就诊且首次诊断为IBD患儿的临床资料进行回顾性分析。将患儿首次症状出现到IBD确诊的时间位于该研究所有IBD患儿这个时间的上四分位数(P76~P100)者定义为“延迟诊断”。采用多因素logistic回归分析探讨消瘦和生长迟缓的危险因素。结果共纳入125例初诊IBD患儿,以克罗恩病为主(91.2%)。消瘦和生长迟缓率分别为42.4%(53例)和7.2%(9例);贫血患儿比例为77.6%(97例)。31例(24.8%)为延迟诊断,其首次症状出现到IBD确诊时间为366~7211 d。多因素logistic回归分析显示,延迟诊断是消瘦和生长迟缓的危险因素(分别OR=2.73、4.42,均P<0.05);年龄与消瘦呈正性关联(OR=1.30,P<0.05)。结论IBD初诊患儿营养状况较差,贫血、消瘦及生长迟缓率较高。延迟诊断与IBD患儿营养不良有关。

Objective To investigate the nutritional status and its influencing factors in children with newly diagnosed inflammatory bowel disease(IBD).Methods A retrospective analysis was conducted on the clinical data of children who were diagnosed with IBD for the first time in Hunan Children's Hospital from January 2015 to December 2021.Diagnostic delay was defined as the time from the symptom onset to IBD diagnosis being in the upper quartile(P76-P100)of all IBD children in the study.Multivariate logistic regression analysis was used to explore the risk factors for emaciation and growth retardation.Results A total of 125 children with newly diagnosed IBD were included,with Crohn's disease being the main type(91.2%).The rates of emaciation and growth retardation were 42.4%(53 cases)and 7.2%(9 cases),respectively,and the rate of anemia was 77.6%(97 cases).Diagnostic delay was noted in 31 children(24.8%),with the time from the symptom onset to IBD diagnosis of 366 to 7211 days.Multivariate logistic regression analysis showed that diagnostic delay was a risk factor for emaciation and growth retardation(OR=2.73 and OR=4.42,respectively;P<0.05)and that age was positively associated with emaciation(OR=1.30,P<0.05).Conclusions Children with newly diagnosed IBD have poor nutritional status,and the rates of anemia,emaciation,and growth retardation are high.Diagnostic delay is associated with malnutrition in children with IBD.