Ockenga J, Süttmann U, Selberg O, Schlesinger A, Meier P N, Gebel M, Schedel I, Deicher H
Abteilung Klinische Immunologie, Medizinische Hochschule Hannover, Germany.
Am J Gastroenterol. 1996 Sep;91(9):1817-22.
Wasting is a major feature of advanced HIV infection. Enteral nutrition via percutaneous endoscopic gastrostomy (PEG) is a safe and efficient therapy in malnutrition, but limited experience exists in wasted HIV patients. Here we report on outcome and risk of PEG-feeding in HIV patients compared with HIV-seronegative patients and with HIV patients without PEG.
In 47 HIV-infected patients, PEG was placed because of wasting (n = 33), neurologic deficits (n = 11), or dysphagia (n = 3). Clinical, immunological, and nutritional data were compared with those of i) 15 HIV patients who refused PEG placement despite an appropriate indication, ii) 76 HIV patients without signs of malnutrition, and iii) 43 miscellaneous PEG patients.
PEG was as safe in HIV-infected as in HIV-seronegative patients. PEG feeding resulted in significant increases of body weight (+3.3 +/- 3.6 kg, p < 0.001), serum albumin concentration (+4.5 +/- 7.2 g/L, p < 0.005), and total iron-binding capacity (+9.5 +/- 11.5 mumol/L, p < 0.001). Moreover, our data indicate that PEG feeding may improve survival in wasted AIDS patients.
PEG feeding is safe and effective in the treatment of the AIDS wasting syndrome. Further prospective investigations are necessary to answer the question of whether treatment of wasting improves patient survival.
消瘦是晚期HIV感染的主要特征。经皮内镜下胃造口术（PEG）进行肠内营养是治疗营养不良的一种安全有效的方法，但在消瘦的HIV患者中经验有限。在此，我们报告与HIV血清阴性患者以及未进行PEG的HIV患者相比，HIV患者接受PEG喂养的结果和风险。
47例HIV感染患者因消瘦（n = 33）、神经功能缺损（n = 11）或吞咽困难（n = 3）而放置PEG。将临床、免疫和营养数据与以下患者进行比较：i）15例尽管有适当指征但拒绝放置PEG的HIV患者；ii）76例无营养不良迹象的HIV患者；iii）43例其他接受PEG的患者。
HIV感染患者接受PEG与HIV血清阴性患者一样安全。PEG喂养导致体重显著增加（+3.3±3.6 kg，p < 0.001）、血清白蛋白浓度增加（+4.5±7.2 g/L，p < 0.005）和总铁结合力增加（+9.5±11.5 μmol/L，p < 0.001）。此外，我们的数据表明PEG喂养可能改善消瘦的艾滋病患者的生存。
PEG喂养在治疗艾滋病消瘦综合征方面是安全有效的。需要进一步的前瞻性研究来回答消瘦治疗是否能提高患者生存率的问题。
