目的:贲门失弛缓症,食道的原发性运动障碍,造成严重的营养不良风险。本研究旨在全面评估未经治疗的门失弛缓症患者的营养状况,将其与功能性胃肠病(FGIDs)病例进行比较,并在一年内进行经口内镜肌切开术(POEM)对营养的影响。
方法:我们进行了一项前瞻性研究,包括连续的贲门失弛缓症,从2021年12月到2022年4月在三级护理中心。生化参数,人体测量学,使用主观整体评估(SGA)和营养不良通用筛查工具进行营养评估.诊断为FGIDs的病例作为对照。
结果:多达118例(41.2±13.9年,61%的男性)患有贲门失弛缓症和200名对照(43.4±11.9岁,69%的男性)被纳入研究。贲门失弛缓症的亚型包括I型(16.9%),II(76.3%)和III(6.8%)。总的来说,中,重度营养不良占38.1%和6.8%,分别。与对照组相比,贲门失弛缓症患者的前白蛋白较低(19.4vs.25.2;p=0.001),血清钙(p=0.012),维生素D(p=0.001),血清铁(p=0.001),三头肌褶皱厚度(p=0.002)和握力(p=0.001)。在单变量分析中,I型贲门失弛缓症,身体质量指数,%重量损失,食管下括约肌压和Eckardt评分是营养不良(SGA)的预测因子.在多变量分析中,贲门失弛缓症的类型,中臂围和低体重指数是贲门失弛缓症患者营养不良的重要预测因素。在一年的随访中,POEM后营养状况显着改善。
结论:贲门失弛缓症患者与FGIDs患者相比,营养不良的风险明显更高。POEM后营养状况明显改善。(NCT05161923)。
OBJECTIVE: Achalasia cardia, a primary motility disorder of the esophagus, poses significant malnutrition risks. This
study aims at comprehensively assessing the nutritional status in untreated
achalasia patients, contrasting it with functional gastrointestinal disorders (FGIDs) cases and impact of per-oral endoscopic myotomy (POEM) on nutrition at one-year.
METHODS: We conducted a prospective
study, including consecutive
achalasia cases, from December 2021 to April 2022 at a tertiary care centre. Biochemical parameters, anthropometry, subjective global assessment (SGA) and malnutrition universal screening tool were used for nutritional assessment. Cases diagnosed with FGIDs served as controls.
RESULTS: As many as 118 cases (41.2 ± 13.9 years, 61% males) with achalasia and 200 controls (43.4 ± 11.9 years, 69% males) were included in the
study. Sub-types of
achalasia included type I (16.9%), II (76.3%) and III (6.8%). Overall, 38.1% and 6.8% cases were moderately and severely malnourished, respectively. As compared to controls, cases with achalasia had lower pre-albumin (19.4 vs. 25.2; p = 0.001), serum calcium (p = 0.012), vitamin D (p = 0.001), serum iron (p = 0.001), triceps fold thickness (p = 0.002) and hand-grip strength (p = 0.001). On univariate analysis, type-I achalasia, body mass index, % weight loss, lower esophageal sphincter pressures and Eckardt scores were predictors of malnourishment (SGA). On multivariate analysis, type of achalasia, mid arm circumference and low body mass index were significant predictors of malnourishment in cases with
achalasia. There was significant improvement in the nutritional status after POEM at one-year follow-up.
CONCLUSIONS: Achalasia patients demonstrate a notably higher risk of malnutrition compared to individuals with FGIDs. Nutritional status significantly improves after POEM. (NCT05161923).