Kolodziejczyk E, Wejnarska K, Dadalski M, Kierkus J, Ryzko J, Oracz G
Department of Gastroenterology, Hepatology and Feeding Disorders, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland.
Department of Gastroenterology, Hepatology and Feeding Disorders, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland.
Pancreatology. 2014 Jul-Aug;14(4):275-9. doi: 10.1016/j.pan.2014.04.030. Epub 2014 May 9.
BACKGROUND/OBJECTIVES: The present study was undertaken to determine the prevalence of malnutrition among children with chronic pancreatitis (CP). Furthermore, we aimed to evaluate the relationship between etiological factors of CP, its clinical characteristics, and the severity of malnutrition.
The study included 208 children with CP (113 girls and 95 boys; mean age: 10.8 years, range: 1.6-18 years), hospitalized at our center between 1988 and 2012. The severity of malnutrition was graded on the basis of Cole's ratios, and its prevalence was analyzed according to the etiological factors of pancreatitis. Moreover, the analysis of discrimination was performed to identify the factors contributing to malnutrition among the following variables: age at CP onset, duration of CP, number of CP exacerbations, the number of ERCPs performed, the grade of pancreatic damage documented on imaging, co-occurrence of diabetes, and the results of 72-h fecal fat quantification.
We documented features of malnutrition in 52 (25%) children with CP, including 36 (17.3%) patients with moderate malnutrition, and 2 (0.96%) with severe malnutrition. There was no significant difference in the prevalence of malnutrition between groups of patients with various etiological factors of chronic pancreatitis. The age at CP onset showed the best discrimination ability of malnourished patients: the mean age at disease onset in a subgroup of malnourished children was significantly higher than in children with Cole's index >85%.
A considerable percentage of children with CP can suffer from clinically significant malnutrition. Later age at CP onset predisposes to development of malnutrition.
背景/目的：本研究旨在确定慢性胰腺炎（CP）患儿中营养不良的患病率。此外，我们旨在评估CP的病因、临床特征与营养不良严重程度之间的关系。
本研究纳入了1988年至2012年间在我们中心住院的208例CP患儿（113例女孩和95例男孩；平均年龄：10.8岁，范围：1.6 - 18岁）。根据科尔比率对营养不良的严重程度进行分级，并根据胰腺炎的病因分析其患病率。此外，进行判别分析以确定以下变量中导致营养不良的因素：CP发病年龄、CP病程、CP发作次数、内镜逆行胰胆管造影（ERCP）操作次数、影像学记录的胰腺损伤程度、糖尿病的合并情况以及72小时粪便脂肪定量结果。
我们记录了52例（25%）CP患儿存在营养不良特征，其中36例（17.3%）为中度营养不良，2例（0.96%）为重度营养不良。不同病因的慢性胰腺炎患者组之间营养不良患病率无显著差异。CP发病年龄对营养不良患者具有最佳判别能力：营养不良儿童亚组的疾病平均发病年龄显著高于科尔指数>85%的儿童。
相当比例的CP患儿可能患有具有临床意义的营养不良。CP发病年龄较晚易导致营养不良的发生。
