Kim Hyun Jin, Kim Young, Cho Jin Min, Oh Seak Hee, Kim Kyung Mo
Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Department of Pediatrics, Kwangju Christian Hospital, Gwangju, Korea.
Yonsei Med J. 2016 Sep;57(5):1185-91. doi: 10.3349/ymj.2016.57.5.1185.
Exclusive enteral nutrition (EEN) therapy effectively induces clinical remission in Crohn's disease (CD). It remains unclear, however, whether partial enteral nutrition (PEN) can maintain remission. This study was performed to determine the abilities of oral EEN and oral PEN to induce and maintain clinical remission in pediatric patients with CD, respectively.
Pediatric patients with CD who received oral EEN at a single center in 2000-2014 were identified retrospectively. Remission rates of the EEN and PEN during the 2 years study period were determined. Risk factors for EEN and PEN failure were identified.
Of the 66 patients who started EEN, 61 (92%) completed the course. Clinical remission was achieved in 88% (58/66) of the patients. All 58 patients with remission continued with PEN: 43 (74%) were treatment adherent. The cumulative remission rates at 1 and 2 years were 67% and 52%, respectively. Differing from EEN, limited therapeutic efficacy of PEN was shown in severe CD patients. Female gender associated significantly with non-adherence.
Oral EEN and PEN effectively induced and maintained remission in a pediatric population. Non-adherence was a limiting factor in the success of therapy.
全肠内营养(EEN)疗法可有效诱导克罗恩病(CD)临床缓解。然而,部分肠内营养(PEN)能否维持缓解仍不清楚。本研究旨在分别确定口服EEN和口服PEN诱导及维持儿童CD患者临床缓解的能力。
回顾性确定2000 - 2014年在单一中心接受口服EEN的儿童CD患者。确定2年研究期间EEN和PEN的缓解率。确定EEN和PEN治疗失败的危险因素。
在开始EEN治疗的66例患者中,61例(92%)完成了疗程。88%(58/66)的患者实现了临床缓解。所有58例缓解患者继续接受PEN治疗:43例(74%)坚持治疗。1年和2年的累积缓解率分别为67%和52%。与EEN不同,PEN在重度CD患者中的治疗效果有限。女性性别与治疗不依从显著相关。
口服EEN和PEN可有效诱导和维持儿童患者的缓解。治疗不依从是治疗成功的限制因素。