Nasr Samya Z, Drury Donna
Pediatric Pulmonology, University of Michigan Health System, Ann Arbor, Michigan 48109-5212, USA.
Pediatr Pulmonol. 2008 Mar;43(3):209-19. doi: 10.1002/ppul.20766.
Cystic fibrosis (CF) is an autosomal recessive disease. It affects multiple body organs. The lungs and pancreas are the most affected which results in progressive lung damage and pancreatic insufficiency. Due to the disease process, CF patients require significantly higher caloric intake than recommended for other individuals. The nutritional goal for CF patients is to achieve normal growth and development and, once genetic potential is reached, to maintain good nutritional status throughout life. Evidence has shown that lung function is closely associated with nutritional status in CF and that nutritional status is an independent predictor of survival. Most CF patients are on a high calorie diet to help achieve normal growth and development and maintain good lung function. Inadequate caloric intake in CF can lead to malnutrition. Malnutrition in CF requires careful, multidisciplinary history taking, physical exam, and overall patient/family assessment. Only by determining the actual cause of the malnutrition can appropriate and safe therapies be used to treat it. Appetite stimulants, although efficacious in treating malnutrition in CF, should only be prescribed if decreased food intake secondary to inadequate appetite is the principal cause of the malnutrition and all other contributing factors have been assessed, ruled-out or treated. In this review, we attempted to summarize the use of several appetite stimulants used in CF and other diseases to improve appetite and maximize caloric intake.
囊性纤维化(CF)是一种常染色体隐性疾病。它会影响多个身体器官。肺部和胰腺受影响最为严重,会导致进行性肺损伤和胰腺功能不全。由于疾病进程,CF患者所需的热量摄入比其他个体的推荐摄入量要高得多。CF患者的营养目标是实现正常生长发育,一旦达到遗传潜力,就要在一生中保持良好的营养状况。有证据表明,CF患者的肺功能与营养状况密切相关,且营养状况是生存的独立预测指标。大多数CF患者采用高热量饮食,以帮助实现正常生长发育并维持良好的肺功能。CF患者热量摄入不足会导致营养不良。CF患者的营养不良需要通过仔细的多学科病史采集、体格检查以及对患者/家庭的全面评估来确定。只有确定营养不良的实际原因,才能使用适当且安全的疗法进行治疗。食欲刺激剂虽然对治疗CF患者的营养不良有效,但只有在因食欲不足导致食物摄入量减少是营养不良的主要原因且所有其他促成因素均已评估、排除或治疗后,才可开具此类药物。在本综述中,我们试图总结几种用于CF及其他疾病的食欲刺激剂的使用情况,以提高食欲并最大化热量摄入。