Pironi L, Candusso M, Biondo A, Bosco A, Castaldi P, Contaldo F, Finocchiaro E, Giannoni A, Mazzuoli S, Orlandoni P, Palozzo A, Panella C, Pastò S, Ruggeri E, Sandri G, Stella E, Toigo G
Center for Chronic Intestinal Failure, Department of Internal Medicine and Gastroenterology, University of Bologna, Via Massarenti, 9-40138 Bologna, Italy.
Clin Nutr. 2007 Feb;26(1):123-32. doi: 10.1016/j.clnu.2006.07.004. Epub 2006 Aug 30.
To determine the prevalence (cases per million inhabitants) of home artificial nutrition (HAN), enteral (HEN) and parenteral (HPN), in Italy, grouped according to administrative regions, patient age and primary disease, and to analyze the impact both of the presence of an HAN regional regulation and of demographic characteristics.
In April 2005, the Regional Coordinators of the Italian Society for Parenteral and Enteral Nutrition (SINPE) recorded all the ongoing cases of HAN using a structured questionnaire and were asked to estimate the representativeness of the collected sample with respect to the total expected HAN.
A total of 6955 cases of HAN (93.5% adults, 6.5% pediatric patients < or = 18 years) were recorded in 16 of the 20 Italian regions (80% of the Italian population; sample representativeness 78%). HAN prevalence 152.6 (83.9% HEN, 16.1% HPN); the HAN range among the regions was: prevalence 28.1-519.8; oncological disease 13.8-75.7%, neurological disease 15.5-79.9%, intestinal failure 1.3-14.0%. An HAN regulation was present in 11 regions. A positive association (P=0.012) was found between the number of years since the regulation was issued and the HAN prevalence, and also between the % neurological patients and the population density (P=0.130) and the % inhabitants > or = 75 years (P=0.040).
The need for HAN regards a great number of patients throughout the country; there are substantial differences between the regions with respect to both the prevalence and the use of HAN in various disease categories. A specific regulation may favor the development of HAN.
确定意大利家庭人工营养（HAN）、肠内营养（HEN）和肠外营养（HPN）的患病率（每百万居民中的病例数），按行政区、患者年龄和原发疾病进行分组，并分析HAN区域法规的存在以及人口统计学特征的影响。
2005年4月，意大利肠内和肠外营养学会（SINPE）的区域协调员使用结构化问卷记录了所有正在进行的HAN病例，并被要求评估所收集样本相对于预期HAN总数的代表性。
在意大利20个地区中的16个地区记录了总共6955例HAN病例（93.5%为成年人，6.5%为18岁及以下儿科患者）（占意大利人口的80%；样本代表性为78%）。HAN患病率为152.6（83.9%为HEN，16.1%为HPN）；各地区HAN范围为：患病率28.1 - 519.8；肿瘤疾病13.8 - 75.7%，神经疾病15.5 - 79.9%，肠衰竭1.3 - 14.0%。11个地区存在HAN法规。发现法规发布后的年限与HAN患病率之间存在正相关（P = 0.012），神经疾病患者百分比与人口密度（P = 0.130）以及75岁及以上居民百分比（P = 0.040）之间也存在正相关。
全国范围内大量患者需要HAN；各地区在HAN患病率以及各类疾病中HAN的使用方面存在显著差异。特定法规可能有利于HAN的发展。
