日本炎症性肠病儿童的生长障碍:多中心前性队列研究
Hirotaka Shimizu1, Ryusuke Nambu2, Nao Tachibana3
1Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan.
Journal of pediatric gastroenterology and nutrition
|August 28, 2025
概括
增长障碍 (GI) 影响患有炎症性肠病 (IBD) 的儿童,特别是年轻的性结肠炎患者. 早期的类固醇节约治疗和量身定制的监测是改善儿科IBD的关键.
科学领域:
- 儿童胃肠病学
- 炎症性肠病研究
- 增长与发展研究
背景情况:
- 在儿童炎症性肠病 (IBD) 中,生长障碍 (GI) 是一个重大问题.
- 了解肠道炎 (UC) 和克罗恩病 (CD) 中的特征和患病率对于有效的治疗至关重要.
- 早期发现和干预对于优化受影响儿童的长期健康结果至关重要.
研究的目的:
- 在被诊断为IBD的儿童中调查生长障碍 (GI) 的患病率和特征.
- 将UC和CD儿童的生长模式和康复率进行比较.
- 在儿科IBD人群中确定风险因素和易受伤害的子组.
主要方法:
- 来自日本儿科IBD登记处的402名UC (n=257) 和CD (n=145) 儿童的前性观察研究 (2012-2020年).
- 使用巴黎分类标准来定义增长障碍 (GI).
- 对307名儿童进行了长度评估,至少进行了两年的随访.
主要成果:
- 在诊断时,UC (6. 2%) 和CD (8. 3%) 的GI患病率相似.
- 在0至4岁时诊断出UC的儿童的消化道发病率显著增加 (35. 3%).
- 在最初的GI患者中,生长恢复在UC (9%) 和CD (50%) 之间较低. 新发性GI发生在23%的UC和16%的CD病例中,持续性GI发生在16%的UC和11%的CD病例中. 长期使用皮质类固醇与持续性肠道疾病有关.
结论:
- 在患有IBD的日本儿童中观察到明显的生长模式,年轻的UC患者尤其容易受到影响.
- 小肠病变与肠道疾病有关,强调需要彻底的小肠评估.
- 针对年龄的,以患者为中心的生长监测和早期的类固醇节约策略对于改善儿科IBD的长期结果至关重要.
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