Lanfranchi G A, Brignola C, Campieri M, Bazzocchi G, Pasquali R, Bassein L, Labò G
Hepatogastroenterology. 1984 Jun;31(3):129-32.
Malnutrition is frequently reported in chronic diseases with involvement of gastrointestinal tract, such as Crohn's disease; however, information about this problem is scarce, and available only for hospitalized patients with severe disease. The aim of this study was to evaluate the nutritional status of 44 consecutive outpatients with Crohn's disease in remission or in a stage of low activity (CDAI less than 250). Eighteen of the patients weighed less than 90% of ideal weight and 5 of these weighed less than 80%. Triceps skinfold, a measure of fat store, was less than or equal to 15th percentile in 30%; arm muscle circumference, indicative of muscle mass, was less than or equal to 15th percentile in 59%. The alteration of weight and arm muscle circumference was greater in patients with midly active disease (p less than 0.005) and in those with ileal and ileocolic involvement. Caloric intake, assessed by a seven day questionnaire, was generally good (35.9 +/- 11 Kcal/kg ideal weight/day) and sufficient to maintain weight. Creatinine height index was elevated in 55% of the whole group. Serum albumin was decreased in only 2 cases, and haemoglobin in only 4. Our results show that malnutrition is a serious problem also in outpatients with Crohn's disease. Anthropometric parameters are more sensitive indicators than conventional laboratory studies.
营养不良在诸如克罗恩病等累及胃肠道的慢性疾病中屡有报道；然而，关于这一问题的信息匮乏，且仅适用于患有严重疾病的住院患者。本研究的目的是评估44例处于缓解期或低活动期（CDAI小于250）的克罗恩病门诊患者的营养状况。其中18例患者体重低于理想体重的90%，其中5例体重低于理想体重的80%。三头肌皮褶厚度（一项脂肪储备指标）在30%的患者中小于或等于第15百分位数；上臂肌肉围度（一项肌肉量指标）在59%的患者中小于或等于第15百分位数。体重和上臂肌肉围度的改变在中度活动期患者（p小于0.005）以及回肠和回结肠受累患者中更为明显。通过为期七天的问卷评估的热量摄入总体良好（35.9±11千卡/理想体重千克/天），足以维持体重。整个组中55%的患者肌酐身高指数升高。仅2例患者血清白蛋白降低，仅4例患者血红蛋白降低。我们的结果表明，营养不良在克罗恩病门诊患者中也是一个严重问题。人体测量参数比传统实验室检查更敏感。
