短肽型全肠内营养疗法对克罗恩病患儿体格生长及营养状态的影响

Impact of short-peptide exclusive enteral nutrition therapy on physical growth and nutritional status in children with Crohn's disease

目的探讨短肽型全肠内营养疗法对活动期克罗恩病(Crohn's disease,CD)患儿的临床诱导缓解作用,以及治疗前后体格生长和营养学指标的变化。方法前瞻性纳入2017年1月—2024年1月入住南京医科大学附属儿童医院消化科的43例活动性CD患儿为研究对象,随机分为药物治疗组(13例)和短肽+药物治疗组(30例),分析两组CD患儿治疗前后儿童CD活动指数、体格生长和营养学指标的变化。结果短肽+药物治疗组CD患儿治疗后儿童CD活动指数评分低于药物治疗组(P<0.05),年龄别体重Z评分、体重指数和白蛋白水平高于药物治疗组(P<0.05)。中重度活动短肽+药物治疗亚组患儿总蛋白水平高于中重度活动药物治疗亚组(P<0.05)。结论短肽型全肠内营养疗法可诱导活动期CD患儿的临床缓解,且能促进其体格生长,改善其营养状态。

Objective To evaluate the clinical efficacy of short-peptide exclusive enteral nutrition(EEN)therapy in inducing remission during active Crohn's disease(CD)in children,as well as changes in physical growth and nutritional indicators before and after treatment.Methods A prospective study included 43 children with active CD who were admitted to the Department of Gastroenterology,Children's Hospital of Nanjing Medical University from January 2017 to January 2024.The participants were randomly divided into a medication treatment group(13 children)and a shortpeptide+medication treatment group(30 children).The changes in the Pediatric Crohn's Disease Activity Index(PCDAI)scores,physical growth,and nutritional indicators before and after treatment were analyzed in both groups.Results The PCDAI scores in the short-peptide+medication treatment group were lower than those in the medication treatment group after treatment(P<0.05).The Z-scores for weight-for-age,body mass index,and albumin levels were higher in the short-peptide+medication treatment group compared to the medication treatment group(P<0.05).In the patients with moderate to severe CD,total protein levels in the short-peptide+medication treatment group were significantly higher than those in the medication treatment group(P<0.05).Conclusions Short-peptide EEN therapy can induce clinical remission in children with active CD and promote their physical growth while improving their nutritional status.