PDF(Pubmed)
Abstract：
Cerebral palsy (CP) results in non-progressive damage to the central nervous system, leading to functional disorders of the gastrointestinal tract and requiring enteral nutrition via gastrostomy in some patients. The aim of the study was to assess the impact of enteral nutrition on intestinal inflammation expressed by stool calprotectin and intestinal permeability determined by fecal zonulin and IFABP, and to determine whether CP affects these parameters. The study group consisted of 30 children with CP, fed enterally (Cerebral Palsy Enteral Nutrition-CPEN), and two reference groups: 24 children with CP, fed orally with a standard diet (CPC-Cerebral Palsy Controls) and 24 healthy children (HC-healthy controls). The differences between these groups and between the combined CP groups (CPG and CPEN + CPC) and HC were analyzed. Fecal zonulin, calprotectin, and intestinal fatty acid-binding protein 2 (IFABP2) levels were determined by ELISA. The concentrations of fecal calprotectin and zonulin were significantly higher in the CPEN group than in the CPC group (p = 0.012, p = 0.025). When comparing the CPG (n = 53) with the HC group (n = 24), statistically significant differences were observed for calprotectin (p = 0.000018, higher in the CPG) and IFABP (p = 0.021, higher in HC). Enteral nutrition was associated in our cohort with increased fecal calprotectin and zonulin. Children with cerebral palsy presented with increased fecal calprotectin but not increased intestinal permeability expressed by stool zonulin.
摘要：
脑瘫（CP）导致中枢神经系统的非进行性损害，导致胃肠道功能障碍，一些患者需要通过胃造口术进行肠内营养。该研究的目的是评估肠内营养对粪便钙卫蛋白表达的肠道炎症和粪便zonulin和IFABP测定的肠通透性的影响。并确定CP是否影响这些参数。研究组由30名CP儿童组成，肠内喂养（脑瘫肠内营养-CPEN），和两个参考组：24名CP儿童，口服标准饮食（CPC-脑瘫对照）和24名健康儿童（HC-健康对照）。分析了这些组之间以及组合CP组（CPG和CPENCPC）和HC之间的差异。粪便zonulin，钙卫蛋白,通过ELISA测定肠脂肪酸结合蛋白2（IFABP2）水平。CPEN组的粪便钙卫蛋白和连蛋白浓度明显高于CPC组（p=0.012，p=0.025）。当比较CPG（n=53）与HC组（n=24）时，观察到钙卫蛋白(p=0.000018,CPG较高)和IFABP(p=0.021,HC较高)的统计学差异。在我们的队列中，肠内营养与粪便钙卫蛋白和zonulin增加有关。脑瘫患儿表现为粪便钙卫蛋白增加，但粪便连蛋白表达的肠通透性没有增加。
