Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Pediatr Pulmonol. 2012 Aug;47(8):743-8. doi: 10.1002/ppul.22507. Epub 2012 Feb 1.
In 2005 the Cystic Fibrosis (CF) Foundation recommended that children with CF maintain a body mass index (BMI) ≥ 50th percentile. Our study evaluated if gastrostomy (GT) placement increases the likelihood of reaching that goal compared to a standardized nutrition protocol.
Retrospective study of 20 children with CF ages 2-20 years with GTs placed from 2005 to 2010. Each case was pair-matched on age, sex, pancreatic status, BMI, and lung function with a nonGT child with CF. Outcome measures included nutritional status and lung function at 6 months and 1 year.
At baseline, mean ± SD BMI Z-scores were similar (cases -1.19 ± 0.60, controls -1.10 ± 0.50; P = 0.10). Cases had a significant 6-month increase in mean BMI Z-score to -0.29 ± 0.84 compared to -1.02 ± 0.67 for controls (P < 0.001). By 1 year, the change in mean BMI Z-score was less different (cases -0.41 ± 0.76, controls -0.71 ± 0.51; P = 0.07). Both groups had stable lung function. From exact logistic regression analysis, the odds ratio for cases compared to controls of reaching BMI ≥ 50th percentile was 9.70 (95% CI: 1.05-484.7; P = 0.04) at 6 months and 3.65 (95%CI: 0.69-25.86; P = 0.16) at 1 year.
Our study suggests that children with CF who receive GTs are more likely to achieve BMI ≥ 50th percentile than matched children without GTs.
2005 年,囊性纤维化基金会(CF 基金会)建议 CF 患儿的体重指数(BMI)维持在第 50 百分位以上。我们的研究评估了胃造口术(GT)与标准化营养方案相比,是否更有可能达到这一目标。
回顾性研究了 2005 年至 2010 年间接受 GT 治疗的 2-20 岁 CF 患儿 20 例。每个病例均按年龄、性别、胰腺状态、BMI 和肺功能与未接受 GT 治疗的 CF 患儿进行配对。观察指标包括 6 个月和 1 年时的营养状况和肺功能。
基线时,平均±SD BMI Z 评分相似(病例组-1.19±0.60,对照组-1.10±0.50;P=0.10)。与对照组(-1.02±0.67)相比,病例组在 6 个月时 BMI Z 评分显著增加至-0.29±0.84(P<0.001)。到 1 年时,平均 BMI Z 评分的变化差异较小(病例组-0.41±0.76,对照组-0.71±0.51;P=0.07)。两组肺功能均稳定。通过精确的逻辑回归分析,与对照组相比,病例组达到 BMI≥第 50 百分位的比值比为 9.70(95%CI:1.05-484.7;P=0.04),在 6 个月和 1 年时分别为 3.65(95%CI:0.69-25.86;P=0.16)。
我们的研究表明,与未接受 GT 治疗的 CF 患儿相比,接受 GT 治疗的 CF 患儿更有可能达到 BMI≥第 50 百分位。