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[中重度脑瘫人群的营养状况:体重之外]

[Nutritional status of a population with moderate-severe cerebral palsy: Beyond the weight].

作者信息

Martínez de Zabarte Fernández José Miguel, Ros Arnal Ignacio, Peña Segura José Luis, García Romero Ruth, Rodríguez Martínez Gerardo

机构信息

Servicio de Pediatría, Hospital Obispo Polanco, Teruel, España.

Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, España.

出版信息

An Pediatr (Engl Ed). 2020 Apr;92(4):192-199. doi: 10.1016/j.anpedi.2019.06.003. Epub 2019 Oct 19.

Abstract

INTRODUCTION

Cerebral palsy (CP) is the most frequent cause of motor disability in the paediatric age. The aim of this article is the study of the nutritional status of patients with CP followed-up in a reference hospital, as well as the relationship between neurological and nutritional state.

MATERIAL AND METHODS

A cross-sectional, observational, descriptive and analytical study was conducted on a sample consisting of 4-15years old patients with CP with Gross Motor Function Classification System (GMFCS) gradesIII-IV-V, from a specialised paediatric hospital reference area. An interview (collection of general data, medications and nutritional habits), anthropometric study and bioimpedance (BIA) measurements were carried out.

RESULTS

The study included 69 patients (recruitment 84.15%), with a mean age of 10.46±0.43years, and 50.7% females. The distribution according to GMFCS scale was: gradeIII (36.2%), gradeIV (29%), and gradeV (34.8%). According to weight for height: moderate malnutrition 21.8% (gradeV: 33.3%), severe malnutrition 5.8% (gradeV: 12.6%), overweight/obesity 23.2% (gradeIII: 24%, gradeIV: 35%). Adequate level of lean mass for height: gradeIII (36%), gradeIV (55%), and gradeV (16.7%). Fat excess: gradeIII (36%), gradeIV (40%), and gradeV (29.2%). Fat mass comparison: BIA 6.89±0.64kg versus anthropometry 5.56±4.43kg.

CONCLUSIONS

In CP grade GMFCSV, the weight deficit associated with a decrease in lean body mass is common. Patients with CP grades GMFCSIII-IV have a significant prevalence of overweight/obesity. Anthropometry is a useful tool for nutritional assessment in children with CP, although fat levels could be underestimated.

摘要

引言

脑瘫(CP)是儿童期运动残疾最常见的原因。本文旨在研究一家参考医院随访的脑瘫患者的营养状况,以及神经状态与营养状况之间的关系。

材料与方法

对一家专业儿科医院参考区域内4至15岁、具有粗大运动功能分类系统(GMFCS)III - IV - V级的脑瘫患者样本进行了横断面、观察性、描述性和分析性研究。进行了访谈(收集一般数据、用药情况和营养习惯)、人体测量学研究和生物电阻抗(BIA)测量。

结果

该研究纳入了69名患者(招募率84.15%),平均年龄为10.46±0.43岁,女性占50.7%。根据GMFCS量表的分布情况为:III级(36.2%)、IV级(29%)和V级(34.8%)。根据身高体重情况:中度营养不良占21.8%(V级:33.3%),重度营养不良占5.8%(V级:12.6%),超重/肥胖占23.2%(III级:24%,IV级:35%)。身高对应的瘦体重水平充足情况:III级(36%)、IV级(55%)和V级(16.7%)。脂肪过量情况:III级(36%)、IV级(40%)和V级(29.2%)。脂肪量比较:BIA测量为6.89±0.64kg,人体测量为5.56±4.43kg。

结论

在GMFCS V级脑瘫患者中,与瘦体重减少相关的体重不足很常见。GMFCS III - IV级脑瘫患者中超重/肥胖的患病率较高。人体测量学是评估脑瘫儿童营养状况的有用工具,尽管脂肪水平可能被低估。

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