胰腺癌病人静息能量消耗与营养状态关系的研究

目的:通过检测胰腺癌病人的静息能量消耗(REE),评估病人代谢变化的情况,探讨其与营养状态的关系。方法:用间接能量测定法检测34例诊断为胰腺癌的病人(试验组)和同期30例腹股沟疝病人(对照组)的REE。通过人体成分分析仪检测机体组成[体质指数(BMI)、肌肉重、去脂体重、脂肪重、细胞内液量(ICF)、细胞外液量(ECF)等],将REE与营养指标作相关性分析。结果:试验组病人的REE非常显著高于地对照组(P<0.01)。呼吸商(RQ)较对照组明显降低(P<0.01)。试验组病人的BMI、体重、肌肉群、去脂体重、脂肪、细胞内液量等与对照组比显著减少(P<0.05);细胞外液量较对照组显著增加(P<0.05)。胰腺癌病人的REE与肌肉重、去脂体重、细胞内液均有显著负相关性(P<0.05),与脂肪重无显著相关性(P>0.05)。胰腺癌各病人REE的变化并不相同,其中REE升高者为55.88%,REE正常者为29.41%,REE降低者为14.71%。结论:胰腺癌病人REE显著增加,营养状况显著低下。REE的升高与营养不良相关性。

The measurement of resting energy expenditure of pancreatic cancer patients and its relation to nutritional status

Objective:Cancer patients are often accompanied by changes in metabolism,and metabolic changes in patients with pancreatic cancer are more obvious.The changes in metabolism can lead to changes in body composition.The study was designed to assess the metabolic changes by detecting resting energy expenditure(REE) of pancreatic cancer patients and to explore the relationship of REE and nutritional status. Methods:The REE of 34 patients who were diagnosed with pancreatic cancer(test group) and 30 cases of inguinal hernia patients(control group) was measured by indirect calorimetry,and body composition was analyzed by body composition analyzer [body mass index(BMI),muscle weight,fat free mass,fat mass,intracellular fluid volume(ICF),extracellular fluid volume(ECF)].The relationships between the REE of pancreatic cancer patients and nutrition indicators were analyzed. Results:Compared with control group,in pancreatic cancer patients,the REE was significantly higher(P<0.01),respiratory quotient(RQ) was significantly lower(P<0.01),nutritional indicators [BMI,body weight,muscle mass,fat free mass,fat,ICF] were significantly decreased,and ECF was significantly higher(P<0.05).The REE of pancreatic cancer patients and muscle weight,fat free mass,intracellular fluid was negatively correlated(P<0.05).The change of REE was not the same in different pancreatic cancer patients,with the increased proportion of 55.88%,the normal proportion of 29.41%,and the reduced proportion of 14.71%.Conclusion:In pancreatic cancer patients,the REE is significantly increased,and the nutritional status is significantly lower.Malnutrition is positively correlated with the elevated REE in pancreatic cancer patients.