Schneider Ana Cláudia Reis, Pinto Raquel Borges, Silveira Themis Reverbel da
Setor de Gastroenterologia Pediátrica, Departamento de Pediatria do Hospital de Clínicas de Porto Alegre, RS, Brazil.
Arq Gastroenterol. 2007 Oct-Dec;44(4):345-9. doi: 10.1590/s0004-28032007000400012.
The malnutrition is a frequent finding in adults with cirrhosis, but the prevalence of nutritional risk and malnutrition is little known in pediatric patients.
To evaluate through anthropometry the presence of nutritional risk and malnutrition in cirrhotic pediatric patients regularly attended at the Pediatric Gastroenterology Service of "Hospital de Clínicas" of Porto Alegre, RS, Brazil.
Cross-sectional study with 42 cirrhotic children and adolescents aged between 3 months and 18 years. The nutritional evaluation was made by the determination of the weight/age, height/age, body mass index and triceps skinfold thickness and arm muscle circumference measurements. Patients considered in nutritional risk were < or = -1,28 Z score which corresponds to < or = 10th percentile, and those under -2,0 Z and < or = 3th percentile were in malnutrition status. According to Child-Pugh criteria, 22 patients were classified as A (mild severity), 15 (moderate) B and 5 C (intense).
The mean weight/age, height/age and body mass index Z scores were, respectively, - 0,38 +/- 1,4 SD, - 0,83 +/- 1,16 SD and 0,17 +/- 1,3 SD. Patients in nutritional risk were 3/42 (weight/age), 8/42 (height/age), 12/37 (triceps skinfold thickness), 9/37 (arm muscle circumference), 2/38 (body mass index); in malnutrition status were 6/42 (weight/age), 7/42 (height/age), 4/37 (triceps skinfold thickness) and 4/37 (arm muscle circumference) and 3/38 (body mass index).
The prevalence of nutritional risk was 32.4% and chronic malnutrition was 16.7%. The index which better reflected the nutritional risk in these patients was triceps skinfold thickness. Chronic malnutrition status occurrence was greater in the height/age index.
营养不良在成年肝硬化患者中很常见，但小儿患者营养风险和营养不良的患病率鲜为人知。
通过人体测量学评估巴西阿雷格里港“临床医院”儿科胃肠病科定期就诊的肝硬化小儿患者中营养风险和营养不良的情况。
对42名年龄在3个月至18岁之间的肝硬化儿童和青少年进行横断面研究。通过测定体重/年龄、身高/年龄、体重指数以及三头肌皮褶厚度和上臂肌肉周长进行营养评估。营养风险患者的Z评分为≤ -1.28，对应于≤第10百分位数，Z评分＜ -2.0且≤第3百分位数的患者处于营养不良状态。根据Child-Pugh标准，22例患者被分类为A（轻度），15例为B（中度），5例为C（重度）。
体重/年龄、身高/年龄和体重指数的平均Z评分分别为 -0.38 ± 1.4标准差、 -0.83 ± 1.16标准差和0.17 ± 1.3标准差。存在营养风险的患者分别为：3/42（体重/年龄）、8/42（身高/年龄）、12/37（三头肌皮褶厚度）、9/37（上臂肌肉周长）、2/38（体重指数）；处于营养不良状态的患者分别为：6/42（体重/年龄）、7/42（身高/年龄）、4/37（三头肌皮褶厚度）、4/37（上臂肌肉周长）和3/38（体重指数）。
营养风险患病率为32.4%，慢性营养不良患病率为16.7%。这些患者中最能反映营养风险的指标是三头肌皮褶厚度。慢性营养不良状态在身高/年龄指数中更为常见。
