Morassutti I, Giometto M, Baruffi C, Marcon M L, Michieletto S, Giometto B, Spinella N, Paccagnella A
Metabolic and Nutrition Unit, Local Health Unit (ULSS 9), Treviso, Italy.
Minerva Gastroenterol Dietol. 2012 Sep;58(3):253-60.
The aim of the study was to assess the consequences of early and systematic nutritional intervention on the clinical conditions of amyotrophic lateral sclerosis (ALS) patients and on the opportunity to maintain a good nutritional status for as long as possible.
Thirty-three subjects with ALS. Protocol Group: 12 subjects (9 M and 3 F) monitored according to a precise nutritional intervention protocol.
21 subjects (10 M and 11 F) monitored before applying the protocol.
Data recorded at the time of initial assessment were compared and expressed as the mean ± standard deviation for the Protocol Group vs. the
BMI (kg/m2) 23.6 ± 4.1 vs. 21.6 ± 3.5; weight loss as a percentage of usual weight 6.6 ± 7.9 vs. 16.3 ± 8.8 (P=0.003). At six months: weight loss as a percentage of usual weight 4.9 ± 6.2 vs. 16.9 ± 10.2 (P=0.002). At 12 months: weight loss as a percentage of usual weight 7.3 ± 7.1 vs. 17.5 ± 11.1 (P=0.03). At the first follow-up visit, fewer patients in the Protocol Group were receiving enteral nutrition (25%) than patients in the CONTROL GROUP (60%). At six-month follow-up visit: 30% vs. 68%. Standard enteral nutrition formulas were used. One year after initial assessment, the mortality rate was 17% for the Protocol Group, whereas it was 24% at six months and 33% after one year for the CONTROL GROUP.
If patients are treated before any significant weight loss occurs, early and specific nutritional intervention allows good nutritional status to be maintained for a longer period; if artificial nutrition is required, standard diets are able to ensure adequate clinical results.
本研究旨在评估早期系统性营养干预对肌萎缩侧索硬化症(ALS)患者临床状况以及尽可能长时间维持良好营养状况机会的影响。
33例ALS患者。方案组:12例受试者(9例男性和3例女性)按照精确的营养干预方案进行监测。
21例受试者(10例男性和11例女性)在应用该方案前进行监测。
将初始评估时记录的数据进行比较,并以方案组与对照组的均值±标准差表示:体重指数(kg/m²)23.6±4.1 对比 21.6±3.5;体重减轻占平常体重的百分比6.6±7.9 对比 16.3±8.8(P=0.003)。6个月时:体重减轻占平常体重的百分比4.9±6.2 对比 16.9±10.2(P=0.002)。12个月时:体重减轻占平常体重的百分比7.3±7.1 对比 17.5±11.1(P=0.03)。在首次随访时,方案组接受肠内营养的患者(25%)少于对照组(60%)。在6个月随访时:分别为30% 和68%。使用的是标准肠内营养配方。初始评估1年后,方案组的死亡率为17%,而对照组在6个月时为24%,1年后为33%。
如果在患者出现明显体重减轻之前进行治疗,早期特异性营养干预可使良好的营养状况维持更长时间;如果需要人工营养,标准饮食能够确保取得足够的临床效果。