Wall Catherine L, McCombie Andrew M, Gearry Richard B, Day Andrew S
Department of Pediatrics, University of Otago, Christchurch, New Zealand.
Department of Medicine and Surgery, University of Otago, Christchurch, New Zealand.
Inflamm Intest Dis. 2019 May;4(1):7-13. doi: 10.1159/000497323. Epub 2019 Mar 20.
Impaired health-related quality of life and higher rates of anxiety and depression are observed in patients with Crohn's disease. This single center study aimed to describe and compare longitudinal psychological outcomes of newly diagnosed Crohn's disease patients treated with standard care or enteral nutrition to induce remission.
Two separate cohorts of patients were recruited from one center and treated with standard care ( = 22) or enteral nutrition ( = 18) to induce disease remission. Disease activity, quality of life, anxiety, and depression were -assessed at diagnosis and month 6.
At baseline, quality of life ( = 40) was not correlated with disease activity; symptoms of anxiety and depression were present in 15 (38%) and 5 (13%) of the 40 patients, respectively. Significant improvements in quality of life ( 0.0001) and anxiety scores ( = 0.002) were observed after 2 weeks of exclusive enteral nutrition, and at month 6 significant improvements in all psychological outcomes were observed. At month 6, patients who received standard care had a significant improvement in quality of life ( = 0.004), but not in anxiety or depression scores, and there were no differences in psychological outcomes between the treatment groups. Overall, 34/40 (85%) patients were in clinical remission at month 6, and a clinically significant quality of life score was achieved by 31/40 (78%).
Patient health-related quality of life and symptoms of anxiety and depression improved as disease activity improved, and 6 months after diagnosis psychological outcomes were similar in patients treated with standard care or enteral nutrition to initially induce remission.
克罗恩病患者存在健康相关生活质量受损以及焦虑和抑郁发生率较高的情况。这项单中心研究旨在描述和比较接受标准治疗或肠内营养诱导缓解的新诊断克罗恩病患者的纵向心理结局。
从一个中心招募了两组独立的患者队列，分别接受标准治疗（n = 22）或肠内营养（n = 18）以诱导疾病缓解。在诊断时和第6个月评估疾病活动度、生活质量、焦虑和抑郁情况。
基线时，生活质量（n = 40）与疾病活动度无相关性；40例患者中分别有15例（38%）和5例（13%）存在焦虑和抑郁症状。在单纯肠内营养2周后，生活质量（P < 0.0001）和焦虑评分（P = 0.002）有显著改善，在第6个月时所有心理结局均有显著改善。在第6个月时，接受标准治疗的患者生活质量有显著改善（P = 0.004），但焦虑或抑郁评分无改善，且治疗组之间心理结局无差异。总体而言，40例患者中有34例（85%）在第6个月达到临床缓解，31例（78%）患者获得了具有临床意义的生活质量评分。
随着疾病活动度改善，患者的健康相关生活质量以及焦虑和抑郁症状得到改善，在诊断6个月后，接受标准治疗或肠内营养初始诱导缓解的患者心理结局相似。
