Ghoshal Uday Chand, Thakur Prabhakar Kumar, Misra Asha
Department of Gastroenterology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India.
JGH Open. 2019 May 14;3(6):468-473. doi: 10.1002/jgh3.12191. eCollection 2019 Dec.
Although achalasia patients are undernourished, studies are scant. We studied: (i) the frequency of malnutrition among these patients and (ii) the effect of pneumatic dilatation (PD) on malnutrition.
A total of 70 adult achalasia patients and 70 healthy controls were evaluated through dietary recall, anthropometry, and biochemical parameters, and patients were reevaluated 6 months after PD.
Patients had lower intake of calories (median, interquartile range [IQR]: 1835.0 [1682.5-1915.0] 2071.5 [1950-2276.2] kcal/day, < 0.001), protein (40.9 [36.3-42.2] 52.9 [45.7-62] g/day, < 0.001), calcium (310 [192.5-392.4] 477.5 [350-560] mg/day, < 0.001), and iron (6.7 [4.7-8.8] 10.1 [7.5-11.50] mg/day, < 0.001) than controls. Patients had lower body mass index (BMI: 19.6 [16.6-22] 22.8 [19.5,29.1], < 0.001), midarm circumference (MAMC; 20 [17.5-23] 24.1 [21.4-28.5], < 0.001), biceps (BSFT; 3.1 [1.9-3.9] 5.5 [3.8-9.2] mm, < 0.001), triceps' skin fold thickness (TSFT; 5 [2.4-7] 7.8 [5.1-9.4] mm, < 0.001), serum protein (7.2 ± 0.8 7.6 ± 0.8 g/dL, = 0.005), and albumin (4.0 [3.5-4.4] 4.1 [3.9-4.2] g/dL, = 0.009). PD increased calories (1803 [950-2400] 2050 [1470-2950] kcal/day), protein intake (41.0 [22-70] 45.0 [37.5-80.0] gm/day), BMI (19.6 [12.8-30.0] 22.2[15.9-30.0] = 0.001 for all), and MAMC (21 [14.1-32.0] 24.2 [15-32.0] cm, = 0.03). Reduced intake was a determinant of malnutrition.
Malnutrition is common in achalasia patients, and PD improved it.
尽管贲门失弛缓症患者存在营养不良，但相关研究较少。我们研究了：（i）这些患者中营养不良的发生率；（ii）气囊扩张术（PD）对营养不良的影响。
通过饮食回顾、人体测量和生化指标对70例成年贲门失弛缓症患者和70例健康对照者进行评估，并在PD术后6个月对患者进行重新评估。
患者的热量摄入较低（中位数，四分位间距[IQR]：1835.0[1682.5 - 1915.0]对2071.5[1950 - 2276.2]千卡/天，<0.001）、蛋白质摄入较低（40.9[36.3 - 42.2]对52.9[45.7 - 62]克/天，<0.001）、钙摄入较低（310[192.5 - 392.4]对477.5[350 - 560]毫克/天，<0.001）以及铁摄入较低（6.7[4.7 - 8.8]对10.1[7.5 - 11.50]毫克/天，<0.001），均低于对照组。患者的体重指数（BMI：19.6[16.6 - 22]对22.8[19.5,29.1]，<0.001）、上臂中部周长（MAMC；20[17.5 - 23]对24.1[21.4 - 28.5]，<0.001）、肱二头肌皮褶厚度（BSFT；3.1[1.9 - 3.9]对5.5[3.8 - 9.2]毫米，<0.001）、肱三头肌皮褶厚度（TSFT；5[2.4 - 7]对7.8[5.1 - 9.4]毫米，<0.001）、血清蛋白（7.2±0.8对7.6±0.8克/分升，=0.005）和白蛋白（4.0[3.5 - 4.4]对4.1[3.9 - 4.2]克/分升，=0.009）均较低。PD使热量摄入增加（1803[950 - 2400]对2050[1470 - 2950]千卡/天）、蛋白质摄入增加（41.0[22 - 70]对45.0[37.5 - 80.0]克/天）、BMI增加（19.6[12.8 - 30.0]对22.2[15.9 - 30.0]，所有均P = 0.001）以及MAMC增加（21[14.1 - 32.0]对24.2[15 - 32.0]厘米，P = 0.03）。摄入量减少是营养不良的一个决定因素。
营养不良在贲门失弛缓症患者中很常见，而PD可改善这种情况。
