囊性纤维化儿童营养状况与临床特征和肺功能的相关性分析  

Correlation of nutritional status with clinical characteristics and lung function in children with cystic fibrosis

作　　者：李东丹[1] 申月琳[2] 王美辰 杨文利[1] 夏露露[1] 张雨晴 赵顺英[2] 闫洁[1] LI Dong-Dan;SHEN Yue-Lin;WANG Mei-Chen;YANG Wen-Li;XIA Lu-Lu;ZHANG Yu-Qing;ZHAO Shun-Ying;YAN Jie(Department of Nutrition,Beijing Children's Hospital,Capital Medical University/National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心/首都医科大学附属北京儿童医院临床营养科,北京100045 [2]国家儿童医学中心/首都医科大学附属北京儿童医院呼吸二科,北京100045

出　　处：《中国当代儿科杂志》2024年第3期275-281,共7页Chinese Journal of Contemporary Pediatrics

摘　　要：目的了解囊性纤维化(cysticfibrosis,CF)儿童的营养状况,并分析营养不良与临床特征、肺功能的关系。方法回顾性分析2016年1月—2023年6月收治的CF患儿的临床资料,比较不同营养状态患儿的临床特征,分析营养不良与肺功能的相关性。结果共纳入52例CF患儿,男童25例(48%),女童27例(52%),年龄7个月至17岁,临床表现主要以呼吸系统(96%,50/52)为主。营养不良发生率为65%(34/52),以中重度营养不良(65%,22/34)为主。营养不良组患儿病程更长,合并消化系统症状比例更高,血清白蛋白降低更明显(P<0.05)。营养不良组患儿第1秒用力呼气量占预测值百分比、第1秒用力呼气量/用力肺活量、用力呼出25%肺活量的呼气流量占预计值百分比、用力呼出50%肺活量的呼气流量占预测值百分比、用力呼出75%肺活量的呼气流量占预测值百分比、最大呼气中期流量占预测值百分比均低于营养正常患儿(P<0.05)。相关性分析显示,体重指数Z评分与上述6个肺功能指标均呈正相关(P<0.05)。结论CF患儿营养不良发生率高,与肺功能下降有关,较高体重指数患儿有更好的肺功能,应重视CF患儿营养筛查评估及合理营养干预。Objective To investigate the nutritional status of children with cystic fibrosis(CF)and understand the correlation between malnutrition and clinical characteristics as well as lung function.Methods A retrospective analysis was performed on clinical data of CF children admitted from January 2016 to June 2023.Clinical characteristics of CF children with different nutritional statuses were compared,and the correlation between malnutrition and lung function was analyzed.Results A total of 52 CF children were included,comprising 25 boys(48%)and 27 girls(52%),aged between 7 months and 17 years.Respiratory symptoms were the predominant clinical manifestations(96%,50/52).The prevalence of malnutrition was 65%(34/52),with moderate/severe malnutrition being the most common(65%,22/34).The malnutrition group had a longer duration of illness,higher proportion of digestive system symptoms,and lower levels of serum albumin(P<0.05).Pulmonary function parameters,including forced expiratory volume in one second as a percentage of the predicted value,ratio of forced expiratory volume in one second to forced vital capacity,forced expiratory flow at 25%of forced vital capacity exhaled,forced expiratory flow at 50%of forced vital capacity exhaled,forced expiratory flow at 75%of forced vital capacity exhaled,and maximum mid-expiratory flow as a percentage of the predicted value,were lower in the malnutrition group compared to the normal nutrition group(P<0.05).Correlation analysis showed body mass index Z-score was positively correlated with the above six pulmonary function parameters(P<0.05).Conclusions The prevalence of malnutrition is high in CF children and is associated with decreased lung function.CF children with higher body mass index have better lung function.Therefore,screening and evaluation of nutritional status as well as appropriate nutritional intervention should be emphasized in CF children.

关 键 词：囊性纤维化 营养不良 肺功能 儿童 

分 类 号：R723.13[医药卫生—儿科]