School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.
J Gastroenterol. 2012 Aug;47(8):872-82. doi: 10.1007/s00535-012-0617-9. Epub 2012 Jun 15.
Crohn's disease is an increasingly global health concern. Currently without a cure, it significantly alters the quality of life of Crohn's disease sufferers and places a heavy financial burden on the community. Recent reports show that the rising prevalence of Crohn's disease is no longer confined to Western countries, with considerable increases seen particularly in Asia. Nutritional problems are often associated with Crohn's disease, most notably in the paediatric population, with underweight and stunting commonly seen at presentation. In addition, linear growth retardation and pubertal delay can also manifest in these younger patients. Therefore, exclusive enteral nutrition has been used as a therapeutic option to treat Crohn's disease, in part to address the nutritional complications of the disease. Exclusive enteral nutrition can improve nutrition as well as induce remission at a rate equivalent to corticosteroids. It is safe particularly with long-term use and can induce mucosal healing, considered the gold standard for therapy, at a rate superior to corticosteroids. Exclusive enteral nutrition has thus become the preferred therapeutic option in many centres for the treatment of paediatric Crohn's disease. This review discusses the role of exclusive enteral nutrition as a therapeutic option for the treatment of Crohn's disease, as well as the latest findings into its mechanisms of action.
克罗恩病是一个日益受到全球关注的健康问题。目前尚无治愈方法，它显著改变了克罗恩病患者的生活质量，并给社区带来了沉重的经济负担。最近的报告显示，克罗恩病的患病率不断上升，不再局限于西方国家，亚洲的增幅尤其显著。营养问题常与克罗恩病有关，尤其是在儿科人群中，就诊时常见体重不足和发育迟缓。此外，线性生长迟缓以及青春期延迟也可能在这些年轻患者中表现出来。因此，肠内营养支持已被用作治疗克罗恩病的一种治疗选择，部分原因是为了解决疾病的营养并发症。肠内营养支持可以改善营养状况，并以相当于皮质类固醇的速度诱导缓解。它尤其在长期使用时是安全的，并可以以优于皮质类固醇的速度诱导黏膜愈合，被认为是治疗的金标准。因此，肠内营养支持已成为许多中心治疗儿童克罗恩病的首选治疗选择。这篇综述讨论了肠内营养支持作为治疗克罗恩病的一种治疗选择的作用，以及其作用机制的最新发现。
