The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 3525433 Haifa, Israel.
Pediatric Gastroenterology & Nutrition Unit, Ruth Children's Hospital, Rambam Medical Center, 3109601 Haifa, Israel.
Can J Gastroenterol Hepatol. 2017;2017:5873158. doi: 10.1155/2017/5873158. Epub 2017 May 8.
Partial enteral nutrition (PEN) may be helpful for the maintenance of remission in pediatric Crohn's disease patients.
To evaluate the efficacy of PEN treatment for preventing clinical relapse.
We retrospectively assessed 42 pediatric Crohn's disease patients who entered clinical remission on 4-12 weeks of exclusive enteral nutrition (EEN) and were maintained on PEN as a supplementary diet. We evaluated the efficacy of the treatment at different time points using the weighted Pediatric Crohn Disease Activity Index (wPCDAI), Physician Global Assessment, laboratory parameters, and growth of each patient. Additionally, we assessed the use of concomitant medications.
The median length of remission with PEN was 6 (0-36) months. Patients' remission was maintained on PEN without concomitant medications for a median time of zero months (0-16). The mean body mass index in the PEN group increased from 18.1 to 18.8 after six months of PEN. The median wPCDAI decreased from 30 at diagnosis to 5.0 after EEN and increased to 7.5 after three months of PEN. Overall, the median wPCDAI decreased by 26.2.
PEN treatment was partially effective in maintaining remission and was able to increase BMI and lower wPCDAI. Most patients required concomitant medication after PEN initiation.
部分肠内营养(PEN)可能有助于维持小儿克罗恩病患者的缓解。
评估 PEN 治疗预防临床复发的疗效。
我们回顾性评估了 42 例小儿克罗恩病患者,他们在接受 4-12 周的完全肠内营养(EEN)后进入临床缓解期,并接受 PEN 作为补充饮食。我们使用加权儿科克罗恩病活动指数(wPCDAI)、医生总体评估、实验室参数和每位患者的生长情况,在不同时间点评估治疗的疗效。此外,我们评估了同时使用药物的情况。
PEN 缓解的中位数为 6(0-36)个月。患者在无同时用药的情况下,PEN 缓解的中位数时间为零个月(0-16)。PEN 组的平均体重指数从 PEN 前的 18.1 增加到 PEN 后 6 个月的 18.8。wPCDAI 从诊断时的中位数 30 降至 EEN 后的 5.0,并在 PEN 后 3 个月增加至 7.5。总体而言,wPCDAI 中位数下降了 26.2。
PEN 治疗在维持缓解方面部分有效,能够增加 BMI 并降低 wPCDAI。大多数患者在开始 PEN 后需要同时使用药物。