Pediatric Gastroenterology Unit, Department of Pediatrics, University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Digestion. 2012;85(4):308-19. doi: 10.1159/000336766. Epub 2012 Jun 8.
Growth retardation, associated with delayed puberty, is a frequent feature in pediatric patients with inflammatory bowel disease (IBD), especially with Crohn's disease. It is mainly induced by malnutrition and the effects of the inflammatory process on the growth hormone/insulin-like growth factor-1 axis or on the growth plate. Therefore, control of disease activity and mucosal healing are paramount to promote growth and adequate pubertal onset. Current therapeutic strategies for maintenance in IBD include anti-inflammatory drugs, immunosuppressives, and, more recently, biologic agents. Although these treatments are efficient in minimizing inflammation and inducing prolonged remission, their long-term effects on growth and final height remain controversial. Furthermore, glucocorticoid therapy, even though very efficient in inducing remission, clearly shows deleterious effects on growth, which is not the case for exclusive enteral nutrition showing comparable results regarding induction of remission. Thus regular assessment of weight, height and pubertal stage is essential in children and adolescents with chronic disease, namely IBD.
生长迟缓与青春期延迟有关，是小儿炎症性肠病（IBD）患者的常见特征，尤其是克罗恩病患者。其主要由营养不良和炎症过程对生长激素/胰岛素样生长因子-1 轴或生长板的影响引起。因此，控制疾病活动和黏膜愈合对于促进生长和适当的青春期开始至关重要。IBD 的维持治疗策略包括抗炎药、免疫抑制剂，以及最近的生物制剂。虽然这些治疗方法在最大限度地减少炎症和诱导长期缓解方面非常有效，但它们对生长和最终身高的长期影响仍存在争议。此外，糖皮质激素治疗虽然在诱导缓解方面非常有效，但对生长的影响明显不利，而单纯肠内营养则没有这种情况，其在诱导缓解方面的效果相当。因此，在患有慢性疾病（即 IBD）的儿童和青少年中，定期评估体重、身高和青春期阶段至关重要。
