Retrospective analysis of nutritional risk and nutritional treatment options in inflammatory bowel disease / 肠外与肠内营养

ABSTRACT

Objective:To understand the nutritional risk in patients with IBD,its related factors and nutritional treatment options.Methods:IBD patients treated in Peking University first hospital from January 2006 to December 2015 were studied.Using the Nutritional risk screening 2002 (NRS2002) nutritional risk assessment of the patients were evaluated.According to the body mass index (BMI),patients were divided into normal BMI group (BMI 18.5 ～ 23.9),low BMI group (BMI ＜ 18.5) and high BMI group (BMI ≥ 24).We analyzed the nutritional risk related factors and compared the difference of nutritional therapy options,regarding the UC and CD patients respectively.Results:A total of 388 patients with IBD were enrolled in the study,with UC 306 and CD 82 patients.The total nutritional risk was 49.5％.Although there was no difference in BMI distribution between UC and CD,CD was more likely to have nutritional risk than UC (CD 64.6％,UC 45.4％,(P =0.002).The nutritional risk of low BMI group was 95.7％.There were no differences in age,sex,and family history in IBD patients for the occurrence of nutritional risk.The more frequently recurrence,severe of disease activity,and the wider rang of disease bring the higher nutritional risk for UC patients.But for CD patients,penetrating type,having a history of surgery and severe of disease activity had higher nutritional risk.Adequate caloric nutrition therapy in patients with CD was 77.4％ higher than that of UC 46.8％,(P ＜ 0.001).It was a main principle of our center that UC patients with severe recurrence should not emphasize enteral nutrition and CD patients should first deal with the contraindications before starting enteral nutrition.Conclusions:IBD patients have a high nutritional risk and CD is more obvious than UC,particularly in low BMI patients.The nutritional risk of patients with UC and CD has its own associated factors.It is safe to treat IBD patients with enteral nutrition as long as the indications and contraindications were well controlled.