24.营养不良英文版.pptx

MalnutritionandObesityProtein-energyMalnutritionOneofTheLeadingCausesofMortalityinChildhoodEtiologyofMalnutrition¾ImproperIntakeofFood(primary)†Insufficientfoodsupply†inadequatefeeding(insufficientsupplementoffood,onlystarch)†poordietaryhabit(foodpreference)†emotionalfactorsEtiologyofMalnutrition¾Inadequateabsorbsionoffood(secondary)†congenitalmalformationcheiloschisis(唇裂,cleftlip)palatoschisis(腭裂,cleftpalate)pyloricobstruction(幽门梗阻)†infectionandAllergy:chronicdiarrheaEtiologyofMalnutrition¾Increasedrequirement†rapidgrowthstates:Infancy,puberty†needsforcatch-upgrowth:pre-terminfant,twinsEtiologyofMalnutrition¾Increasedenergyexpenditure†metabolicdiseases:diabetes,Graves’disease†infection:chronicfever,TB,†malignenttumorEtiologyofMalnutrition¾Aabnormalloss:proteinuria(nephrosis)Pathophysiology¾carbohydratemetabolismenergyexcessglycogenstoredasfatliver&musclePathophysiology¾Fatmetabolisminsufficientintakeofenergy↓↓fatsynthesis↓&fatanalysis↑↓↓loadforliver↑&lossofsubcutaneousfat↓fattyinfiltrationofliverPathophysiology¾Proteinmetabolism‡Insufficientintakeofprotein‡Insufficientintakeofcarbohydrate↓→proteinanalysis↑‡serumalbumin↓→serumcolloidosmoticpressure↓(albumin<20g/L)→edema