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实施苯丙酮尿症从儿科到成人服务的过渡计划:由成人团队进行两年随访后的结果

Implementing a Transition Program from Paediatric to Adult Services in Phenylketonuria: Results After Two Years of Follow-Up with an Adult Team.

作者信息

Peres Maria, Almeida Manuela F, Pinto Élia J, Carmona Carla, Rocha Sara, Guimas Arlindo, Ribeiro Rosa, Martins Esmeralda, Bandeira Anabela, MacDonald Anita, Rocha Júlio C

机构信息

Centro de Genética Médica, Centro Hospitalar Universitário do Porto (CHUP), 4099-028 Porto, Portugal.

Faculdade de Ciências da Nutrição e Alimentação, UP, 4150-177 Porto, Portugal.

出版信息

Nutrients. 2021 Feb 28;13(3):799. doi: 10.3390/nu13030799.

Abstract

We aimed to report the implementation of a phenylketonuria (PKU) transition program and study the effects of follow-up with an adult team on metabolic control, adherence, and loss of follow-up. Fifty-five PKU patients were analysed in the study periods (SP): 2 years before (SP1) and after the beginning of adult care (SP2). Retrospective data on metabolic control and number of clinic appointments were collected for each SP, and protein intakes were analysed. In SP2, three patients (6%) were lost to follow-up. There was a small but statistically significant increase in median number of annual blood spots from SP1 to SP2: 11 (7-15) vs. 14 (7-20); = 0.002. Mean ± SD of median blood Phe remained stable (525 ± 248 µmol/L vs. 552 ± 225 µmol/L; = 0.100); median % of blood Phe < 480 µmol/L decreased (51 (4-96)% vs. 37 (5-85)%; = 0.041) and median number of clinic appointments increased from SP1 to SP2: (5 (4-6) vs. 11 (8-13); < 0.001). No significant differences were found regarding any parameter of protein intake. Our results suggest that the implementation of an adult service was successful as impact on metabolic control was limited and attendance remained high. Continuous dietetic care likely contributed to these results by keeping patients in follow-up and committed to treatment.

摘要

我们旨在报告苯丙酮尿症(PKU)过渡计划的实施情况,并研究成人团队随访对代谢控制、依从性和失访情况的影响。在研究期间(SP)对55例PKU患者进行了分析:成人护理开始前2年(SP1)和开始后(SP2)。收集了每个SP期关于代谢控制和门诊预约次数的回顾性数据,并分析了蛋白质摄入量。在SP2期,3例患者(6%)失访。从SP1到SP2,每年血斑中位数有小幅但具有统计学意义的增加:11(7 - 15)对14(7 - 20);P = 0.002。血苯丙氨酸中位数的平均值±标准差保持稳定(525 ± 248 μmol/L对552 ± 225 μmol/L;P = 0.100);血苯丙氨酸<480 μmol/L的中位数百分比下降(51(4 - 96)%对37(5 - 85)%;P = 0.041),从SP1到SP2门诊预约中位数增加:(5(4 - 6)对11(8 - 13);P < 0.001)。在蛋白质摄入的任何参数方面均未发现显著差异。我们的结果表明,成人服务的实施是成功的,因为对代谢控制的影响有限且就诊率仍然很高。持续的饮食护理可能通过使患者持续接受随访并坚持治疗促成了这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2e5/8001271/da793bad2f5f/nutrients-13-00799-g001.jpg

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