Niseteo Tena, Sila Sara, Trivić Ivana, Mišak Zrinjka, Kolaček Sanja, Hojsak Iva
Referral Centre for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, Zagreb, Croatia.
School of Medicine, University of Zagreb, Zagreb, Croatia.
Nutr Clin Pract. 2022 Apr;37(2):435-441. doi: 10.1002/ncp.10752. Epub 2021 Aug 2.
Data on the efficacy of the newly established dietetic treatment of Crohn's disease (CD), the CD exclusion diet (CDED), are scarce. The aim of this study was to provide real-world data on the efficacy of CDED in comparison with exclusive enteral nutrition (EEN) for remission induction.
A retrospective analysis of children diagnosed with CD who were treated with CDED + partial EN (PEN) or with EEN was performed. Eighty percent of the children assigned to CDED + PEN underwent 1-2 weeks of EEN prior to CDED + PEN. For all children, data from the medical charts were extracted before the introduction of diet therapy and at the end of EEN or CDED + PEN phase 1.
A total of 61 patients (49.2% females; median age, 14.4 years [minimum: 6.7, maximum: 17.9]) were included in the study; 42 children (68.9%) achieved remission, 27 of 41 (65.9%) received EEN and 15 of 20 (75.0%) received CDED + PEN. There was no significant difference in the failure of nutrition therapy between the two groups (P = .469). Patients receiving CDED + PEN had significantly higher weight gain (P = .002) and increases in body mass index z-score (P = .001) compared with patients who received EEN alone.
Treatment with CDED + PEN (with prior 1-2 weeks of EEN) has comparable efficacy to EEN therapy alone in inducing remission in children with CD, and it leads to better weight gain. Further studies are needed to confirm these results.
关于新建立的克罗恩病（CD）饮食疗法即CD排除饮食（CDED）疗效的数据稀缺。本研究的目的是提供CDED与全肠内营养（EEN）相比诱导缓解疗效的真实世界数据。
对诊断为CD且接受CDED + 部分肠内营养（PEN）或EEN治疗的儿童进行回顾性分析。分配至CDED + PEN组的儿童中有80%在CDED + PEN治疗前接受了1 - 2周的EEN。对于所有儿童，从病历中提取饮食治疗开始前以及EEN或CDED + PEN第1阶段结束时的数据。
本研究共纳入61例患者（女性占49.2%；中位年龄14.4岁[最小：6.7岁，最大：17.9岁]）；42例儿童（68.9%）实现缓解，41例中的27例（65.9%）接受EEN，20例中的15例（75.0%）接受CDED + PEN。两组营养治疗失败率无显著差异（P = 0.469）。与仅接受EEN的患者相比，接受CDED + PEN的患者体重增加显著更高（P = 0.002），体重指数z评分增加显著更高（P = 0.001）。
CDED + PEN治疗（之前有1 - 2周的EEN）在诱导CD儿童缓解方面与单独的EEN治疗疗效相当，且体重增加情况更好。需要进一步研究来证实这些结果。
