Leite H P, de Camargo Carvalho A C, Fisberg M
Escola Paulista de Medicina-UNIFESP, São Paulo.
Arq Bras Cardiol. 1995 Nov;65(5):403-7.
To assess the nutritional status of children with congenital heart disease with left-to-right shunt and the nutritional disturbances related to the presence of pulmonary hypertension (PH).
In a prospective study, the nutritional status of 30 children with left-to-right shunt (16 with and 14 without PH) was determined by anthropometric parameters and plasma proteins albumin, transferrin and prealbumin. Frequency and extent of nutritional disturbances were analysed in relation to the presence of PH. A control group of 20 well-nourished children was formed, aiming to compare the values of the serum proteins.
The nutritional classification according to Waterlow's criteria showed an overall prevalence of malnutrition of 83.3%, which was higher in those with PH (p = 0.0140). This patient's group was more wasted than the group without PH (median z score of weight for height -1.65 vs -0.78). There was a high occurrence of measurements of arm fat area below the 5th percentile, which were similar in both groups. Serum levels of albumin and prealbumin were significantly lower in children with congenital heart disease than in the control group and transferrin values were similar in both.
The prevalence of malnutrition was high. The presence of PH was associated with higher nutritional disturbance. The nutritional assessment may be a good way to identify diagnostic groups at particular risk of failure to thrive. This can be useful in planning a management which ensures these patients to achieve adequate nutritional supplementation in early life.
评估左向右分流型先天性心脏病患儿的营养状况以及与肺动脉高压（PH）相关的营养紊乱情况。
在一项前瞻性研究中，通过人体测量参数以及血浆蛋白白蛋白、转铁蛋白和前白蛋白来确定30例左向右分流型患儿（16例有PH，14例无PH）的营养状况。分析营养紊乱的频率和程度与PH存在情况的关系。组建了一个由20名营养良好儿童组成的对照组，旨在比较血清蛋白的值。
根据沃特洛标准进行的营养分类显示，总体营养不良患病率为83.3%，在有PH的患儿中更高（p = 0.0140）。该患儿组比无PH组更消瘦（身高别体重的中位数z评分分别为-1.65和-0.78）。两组中手臂脂肪面积测量值低于第5百分位数的发生率都很高。先天性心脏病患儿的血清白蛋白和前白蛋白水平显著低于对照组，而转铁蛋白值在两组中相似。
营养不良患病率很高。PH的存在与更高的营养紊乱相关。营养评估可能是识别特别有生长发育不良风险的诊断组别的好方法。这对于规划确保这些患者在生命早期获得充足营养补充的管理措施可能有用。
