营养康复对厌食症青少年胃动力和躯体化的影响。
Effect of nutritional rehabilitation on gastric motility and somatization in adolescents with anorexia.
机构信息
Division of Pediatric Gastroenterology, Nationwide Children's Hospital, Columbus, OH, USA.
出版信息
J Pediatr. 2013 Sep;163(3):867-72.e1. doi: 10.1016/j.jpeds.2013.03.011. Epub 2013 Apr 13.
OBJECTIVE
To examine gastric function, as well as the presence of somatic complaints, anxiety symptoms, and functional gastrointestinal disorders (FGIDs), in adolescents with anorexia nervosa (AN) before and after nutritional rehabilitation.
STUDY DESIGN
Sixteen females with AN and 22 healthy controls with similar demographic profiles were included. Gastric emptying (measured as residual gastric volume) and gastric accommodation (measured as postprandial antral diameter) were assessed with abdominal ultrasonography. Participants completed the Children's Somatization Inventory (CSI), the Screen for Child Anxiety-Related Emotional Disorders, and the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version. All testing was repeated 3-4 months later.
RESULTS
Body mass index in the AN group improved over time (P = .012). Fasting gastric parameters were similar in the 2 groups. Maximum postprandial antral diameter was significantly greater in controls compared with the AN group (P = .008). Only adolescents with AN demonstrated a significant increase in maximum postprandial diameter at repeat testing (P = .009). There was no difference in residual gastric volume between the 2 groups. Initial CSI scores were higher in adolescents with AN (P < .0001), including higher scores for nausea and abdominal pain. CSI scores were significantly lower in adolescents with AN (P = .035). Initial scores on the Screen for Child Anxiety-Related Emotional Disorders were significantly higher in adolescents with AN (P = .0005), but did not change over time. Adolescents with AN met significantly more criteria for FGIDs (P = .003).
CONCLUSION
Adolescents with AN have impaired gastric accommodation that improves after nutritional rehabilitation, have significantly more somatic complaints, and meet more criteria for anxiety disorders and FGIDs. After nutritional rehabilitation, somatization improves and FGIDs become less common, but symptoms of anxiety persist.
目的
探讨神经性厌食症（AN）青少年在营养康复前后的胃功能、躯体症状、焦虑症状和功能性胃肠疾病（FGIDs）的发生情况。
研究设计
纳入 16 名 AN 女性和 22 名具有相似人口统计学特征的健康对照者。采用腹部超声评估胃排空（以残胃容量表示）和胃容纳（以餐后胃窦直径表示）。参与者完成儿童躯体化量表（CSI）、儿童焦虑相关情绪障碍筛查量表和罗马 III 版儿童胃肠症状问卷。所有测试均在 3-4 个月后重复进行。
结果
AN 组的体重指数随时间推移而改善（P =.012）。两组空腹胃参数相似。与 AN 组相比，对照组的最大餐后胃窦直径明显更大（P =.008）。仅 AN 组青少年在重复测试时最大餐后直径显著增加（P =.009）。两组间残胃容量无差异。AN 组青少年 CSI 初始评分较高（P <.0001），包括恶心和腹痛评分较高。AN 组青少年 CSI 评分显著降低（P =.035）。AN 组青少年儿童焦虑相关情绪障碍筛查量表初始评分显著较高（P =.0005），但随时间推移无变化。AN 组青少年符合更多 FGIDs 标准（P =.003）。
结论
AN 青少年存在胃容纳受损，经营养康复后可改善，且躯体症状明显更多，焦虑障碍和 FGIDs 标准符合更多。营养康复后，躯体化改善，FGIDs 变得不那么常见，但焦虑症状持续存在。
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