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中国一家儿科诊所中蛋白质-能量营养不良的病因模式

Etiological Patterns of Protein-Energy Malnutrition in a Pediatric Clinic in China.

作者信息

Tang Mei, Wang Yini, Yang Fan, Xiang Yun, Wu Jinhui

机构信息

Pediatric Department, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.

出版信息

Med Sci Monit. 2025 Apr 9;31:e946284. doi: 10.12659/MSM.946284.

Abstract

BACKGROUND Protein-energy malnutrition (PEM) often occurs within 5 years of age. Untreated PEM in early childhood can affect growth and cognitive function later in life. However, the etiologies of PEM in children are still poorly explored. This study investigated the etiological distribution of PEM in children attending a pediatric health clinic. MATERIAL AND METHODS The study involved 286 children with PEM who visited the West China Second University Hospital Child Healthcare for Xinchuan West China Center for Child Development and Excellence from January to December 2022. Patients were divided into moderate and mild PEM groups according to the severity of PEM. A retrospective analysis of the etiology of PEM was conducted. RESULTS The top 5 etiologies of PEM were food allergy (FA) (57.0%), small for gestational age (SGA) (26.6%), dietary behavior problems (14.3%), premature infants (8.0%), and recurrent respiratory tract infections (RRTI) (4.5%). The proportions of SGA and RRTI patients in the moderate PEM group were significantly greater than the mild PEM group (P<0.001). The proportion of patients with 2 or more etiologies in the moderate PEM group was significantly greater than the mild PEM group (P<0.001). CONCLUSIONS The primary reasons for PEM in the investigated children were FA and SGA. Moderate PEM cases were mostly attributed to multiple etiologies. A multidisciplinary management approach involving pediatricians, nutritionists, and social workers is essential for addressing the complex needs of affected children. The importance of early diagnosis and timely management should be emphasized to reduce the number of PEM cases.

摘要

背景 蛋白质能量营养不良(PEM)常见于5岁以内。儿童期未经治疗的PEM会影响其日后的生长和认知功能。然而,儿童PEM的病因仍未得到充分探究。本研究调查了在儿科健康诊所就诊的儿童中PEM的病因分布情况。

材料与方法 本研究纳入了2022年1月至12月期间前往四川大学华西第二医院儿童医疗保健科新川华西儿童发展卓越中心就诊的286例PEM患儿。根据PEM的严重程度将患者分为中度和轻度PEM组。对PEM的病因进行回顾性分析。

结果 PEM的前5大病因依次为食物过敏(FA)(57.0%)、小于胎龄儿(SGA)(26.6%)、饮食行为问题(14.3%)、早产儿(8.0%)和反复呼吸道感染(RRTI)(4.5%)。中度PEM组中SGA和RRTI患者的比例显著高于轻度PEM组(P<0.001)。中度PEM组中具有2种或更多病因的患者比例显著高于轻度PEM组(P<0.001)。

结论 所调查儿童中PEM的主要原因是FA和SGA。中度PEM病例大多归因于多种病因。涉及儿科医生、营养师和社会工作者的多学科管理方法对于满足受影响儿童的复杂需求至关重要。应强调早期诊断和及时管理的重要性,以减少PEM病例的数量。

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Determinants of malnutrition among children: A systematic review.儿童营养不良的决定因素:系统评价。
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