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为进一步评价Harris-Benedict公式估算能量消耗的临床应用价值,采用开放式间接代谢测定仪测定65例健康成人及35例稳定期慢阻肺(COPD)患者的静息能量消耗(REE)。结果表明,65例健康成人REE为1492.15±250.83Kcal/d,比Harris-Benedict公式估算的基础能量消耗(BEE)高4.3%(P<0.05)。35例稳定期COPD患者REE为1521.29±208.33Kcal/d,比BEE高20.39(P<0.001),COPD患者公斤体重REE明显高于对照组(P<0.001),且与体重占理想体重百分比及第一秒时间肺活量占预计值百分比呈显著负相关(γ值分别为-0.6,-0.57,P<0.001)。提示CDPD患者静息能量消耗增高,且随体重及气道阻力的变化差异增大,应用HBE公式时需对其矫正。 相似文献
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外科危重病人静息能量消耗测定及评价 总被引:2,自引:1,他引:2
采用开放式间接测热法对58例严重感染或创伤病人进行静息能量消耗(REE)测定,以同期外科非应激状态病人为对照组。结果示危重病人组MREE平均为6983±812kJ/d,比对照组5272±469kJ/d增高30.2%(P<0.001),也明显高于按Haris-Benedict公式估算的基础能量消耗值(BEE)(5799±623kJ/d),REE与BEE的平均比值为1.24±0.12,每千克体重的REE值平均为124.3±10.5kJ/d,危重病人每分钟通气量、O2耗量及CO2产生量均明显高于对照组;而呼吸商明显低于对照组。危重病人APACHEⅡ评分平均值为19.4±5.3,与REE之间有显著相关(P<0.05)。 相似文献
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目的观察血糖控制良好的2型糖尿病患者静息能量消耗(REE)的特点。方法采用代谢车测量45例血糖稳定的2型糖尿病患者的REE,记录其一般情况、生化指标、Harris-Benedict和Owen公式计算基础能量消耗预测值,并进行比较分析。结果血糖稳定的2型糖尿病患者的静息能量消耗实测值与Harris-Benedict及Owen公式预测值比较差异无统计学意义(P〉0.05),相关分析显示REE与性别、年龄、体重、身高、体表面积、去脂组织显著相关(P〈0.05),与体重指数、脂肪组织、空腹血糖、餐后2h血糖、糖化血红蛋白、总胆固醇、三酰甘油、总蛋白、白蛋白、血红蛋白无相关性(P〉0.05),多元逐步回归分析显示去脂组织和年龄与REE关系最密切。结论血糖良好的2型糖尿病患者的REE并不增高,决定其REE的因素与健康个体相似,测定REE能更好地指导糖尿病的医学营养治疗。 相似文献
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恶性肿瘤病人静息能量消耗研究的进展 总被引:4,自引:0,他引:4
处于不同生理或病理状态的机体 ,能量代谢特征不尽相同。在癌症病人中 ,由于肿瘤生长以及由此产生的机体代谢变化 ,使得肿瘤病人的能量代谢有其特殊性。本文对肿瘤病人的静息能量消耗研究进展进行了综述。一般认为 ,恶性肿瘤病人术前静息能量代谢较正常人有所升高 ,但有资料显示某些恶性肿瘤病人术前能量代谢并无变化。肿瘤部位、大小、分期、分型、治疗措施等的不同 ,对人体代谢有不同影响 ,且不同资料之间还存在着彼此矛盾之处 相似文献
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Objective To investigate the features of resting energy expenditure (REE) in patients with well controlled type 2 diabetes mellitus (T2DM). Methods Totally 45 T2DM patients with stable blood glucose were enrolled. The general conditions, biochemical indicators, measurements of REE ( MREE), and basal energy expenditure (BEE) calculated with Harris-Benedict formula (HBEE) and Owen formula (OBEE) were recorded and compared. Results MREE had no significant difference with HBEE or OBEE in T2DM patients with stable blood glucose (P > 0. 05). Correlation analysis showed that REE was significantly correlated with gender, age, body weight, body height, body surface area, and fat-free mass ( all P < 0.05 ), but was not correlated with body mass index, fat mass, fasting plasma glucose, postprandial plasma glucose, haemoglobin Alc, total cholesterol, triglyceride, total protein, albumin, and haemoglobin (P > 0. 05 ). Multiple regression analysis showed that fat free mass and age had the closest correlation with REE. Conclusions REE does not increase in T2DM patients with well controlled blood glucose. Factors that influence their REE are similar with healthy individuals. Determi nation of REE can provide useful information for the nutrition treatment of T2DM. 相似文献
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目的 探讨机械通气危重患儿的静息能量消耗变化,比较公式估算与间接测热法(IC)所测得的能量消耗之间的差异,分析影响危重患儿代谢状态的可能因素。方法 前瞻性收集2012年9月至2013年9月入住上海儿童医学中心重症监护室、行呼吸机辅助通气、满足IC要求的内科危重症患儿共56例,于机械通气第1、4、7、10天应用代谢车测定其静息能量消耗,并记录患儿的一般临床资料。结果 对56例患儿行IC测定130次,所测得的静息能量消耗值(MREE)在机械通气第1、4、7、10天间比较差异无统计学意义(P=0.379)。MREE与Schofield及WHO公式估算值(PEE)比较差异虽无统计学意义(P值分别为0.917和0.995),但一致性较差(R2值分别为0.185和0.322)。患儿在机械通气第1天的代谢状态仅与年龄(P=0.000)和身高(P=0.027)相关,与疾病严重程度和临床结局均无关联。结论 机械通气危重患儿的静息能量消耗IC法实测值随机械通气时间变化并不显著,预测公式估算的静息能量消耗值与IC法实际测量值之间一致性较差。建议将IC应用于重症监护病房,指导危重患儿个体化营养支持治疗,以改善患儿临床结局。 相似文献
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胰腺癌病人静息能量消耗与营养状态关系的研究 总被引:1,自引:0,他引:1
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。 相似文献
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新生儿静息能量消耗受多种因素影响,而且新生儿的能量代谢变化率很大。个体能量消耗的确定能指导合理营养支持,预防过低或过度喂养。预计公式仅考虑到单一因素对能量消耗的影响,所以不能正确估计能量消耗,要正确的估计能量需要应对新生儿进行间接能量测定。 相似文献
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颅脑损伤病人静息能量消耗的观测 总被引:1,自引:0,他引:1
目的 研究不同颅脑损伤病人伤后静息能量的变化。方法 用开放式间接测热法测定40例不同程度颅脑损伤病人伤后前5天的氧耗量(VO2)、二氧化碳生成量(VCO2)、呼吸商(RQ)、静息能量消耗(REE)和24小时尿氮排出量。结果 有脑损伤组患者伤后氧耗量、静息能量消耗、24小时尿氮排出量比无脑损伤组明显增加,且与脑损伤程度成正比。结论 颅脑损伤患者脑组织和全身处于高能量代谢状态,对氧和能量的需求急剧增加,应根据损伤程度合理、适时地补充营养,以利康复。 相似文献
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Energy Expenditure After Liver Resection: Validation of a Mobile Device for Estimating Resting Energy Expenditure and an Investigation of Energy Expenditure Change After Liver Resection 下载免费PDF全文
Michael J. Hughes MBChB MRCS Ewen M. Harrison PhD FRCS Stephen J. Wigmore MD FRCS 《JPEN. Journal of parenteral and enteral nutrition》2017,41(5):766-775
Background: Resting energy expenditure (REE) is the major component of total energy expenditure. REE is traditionally performed by indirect calorimetry (IC) and is not well investigated after liver surgery. A mobile device (SenseWear Armband [SWA]) has been validated when estimating REE in other clinical settings but not liver resection. The aims of this study are to validate SWA vs IC, quantify REE change following liver resection, and determine factors associated with REE change. Materials and Methods: Patients listed for open liver resection prospectively underwent IC and SWA REE recordings pre‐ and postoperatively. In addition, the SWA was worn continuously postoperatively to estimate daily REE for the first 5 postoperative days. To determine acceptability of the SWA, validation analysis was performed. To assess REE change, peak postoperative REE was compared with preoperative levels. Factors associated with REE change were also analyzed. Results: SWA showed satisfactory validity compared with IC when estimating REE, although postoperatively, the 95% levels of agreement (–5.56 to 3.18 kcal/kg/d) may introduce error. Postoperative REE (median, 23.5 kcal/kg/d; interquartile range [IQR], 22.6–25.7 kcal/kg/d) was significantly higher than predicted REE (median, 19.7 kcal/kg/d; IQR, 19.1–21.0 kcal/kg/d; P < .0001). Median REE rise was 11% (IQR, –1% to 25%). Factors associated with REE rise of >11% were age (P = .017) and length of operation (P = .03). Conclusions: SWA offers a suitable alternative to IC when estimating postoperative REE, but the magnitude of the error (8.74 kcal/kg/d) could hinder its accuracy. REE quantification after liver resection is important to identify patients who could be prone to energy imbalance and therefore malnutrition. 相似文献
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Yimin Chen MS RD CNSC Jennifer Kintner MS RD CSP Sam K. Rifkin MS RD Kathryn S. Keim PhD RD Christy C. Tangney PhD FACN CNS 《JPEN. Journal of parenteral and enteral nutrition》2016,40(6):877-882
Background:There is no consensus whether resting energy expenditure (REE) following orthotopic liver transplantation (OLT) is altered. Methods: The objectives of this investigation were to describe changes in measured REE (mREE) using indirect calorimetry in 25 OLT patients on days 5, 10, and 15 after baseline (within 72 hours following OLT) and compare mREE changes with those calculated with 2 predicted equations for energy expenditure (pREE): the Harris‐Benedict and Schofield equations. Results: Patients were 57 ± 5.4 years of age, 44% were male, 36% were black, and 72% had liver disease of viral etiology. Measured REE (at baseline and days 5, 10, and 15, per kcal/d: 1832 ± 952, 1565 ± 383, 1538 ± 345, 1578 ± 418) and kcal per kilogram of body weight (22.7 ± 12.8, 18.4 ± 4, 18.7 ± 3.8, 21 ± 6.5) did not change over time. In contrast, changes in pREE based on either the Harris‐Benedict (P < .001) or Schofield (P = .006) equation using measured weights at each corresponding time point and lowest body weight during the study to estimate dry weight were significant. Conclusions: Wide ranges in both mREE and mREE expressed per kilogram of body weight at each study time point were observed in contrast to pREE, which declined by day 15. The observed differences in mREE over time suggest indirect calorimetry is indicated if available following OLT. Additional research is warranted to determine the most appropriate predictive equation with suitable stress factors to use when indirect calorimetry is not available. 相似文献
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Brent A. Anderegg PharmD BCPS Cathy Worrall BSN RN PharmD BCPS BCNSP English Barbour RD CNSD Kit N. Simpson DrPH Mark DeLegge MD 《JPEN. Journal of parenteral and enteral nutrition》2009,33(2):168-175
Background: Several methods are available to estimate caloric needs in hospitalized, obese patients who require specialized nutrition support; however, it is unclear which of these strategies most accurately approximates the caloric needs of this patient population. The purpose of this study was to determine which strategy most accurately predicts resting energy expenditure in this subset of patients. Methods: Patients assessed at high nutrition risk who required specialized nutrition support and met inclusion and exclusion criteria were enrolled in this observational study. Adult patients were included if they were admitted to a medical or surgical service with a body mass index ≥ 30 kg/m2. Criteria excluding patient enrollment were pregnancy and intolerance or contraindication to indirect calorimetry procedures. Investigators calculated estimations of resting energy expenditure for each patient using variations on the following equations: Harris‐Benedict, Mifflin–St. Jeor, Ireton‐Jones, 21 kcal/kg body weight, and 25 kcal/kg body weight. For nonventilated patients, the MedGem handheld indirect calorimeter was used. For ventilated patients, the metabolic cart was used. The primary endpoint was to identify which estimation strategy calculated energy expenditures to within 10% of measured energy expenditures. Results: The Harris‐Benedict equation, using adjusted body weight with a stress factor, most frequently estimated resting energy expenditure to within 10% measured resting energy expenditure at 50% of patients. Conclusion: Measured energy expenditure with indirect calorimetry should be employed when developing nutrition support regimens in obese, hospitalized patients, as estimation strategies are inconsistent and lead to inaccurate predictions of energy expenditure in this patient population. 相似文献
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Predictive Equations Are Inaccurate in the Estimation of the Resting Energy Expenditure of Children With End‐Stage Liver Disease 下载免费PDF全文
Andrea Carpenter RD BSc Vicky Lee Ng MD FRCPC Karen Chapman PhD RN Simon C. Ling MBChB Marialena Mouzaki MD MSc 《JPEN. Journal of parenteral and enteral nutrition》2017,41(3):507-511
Background and Objectives: Malnutrition is common in children with end‐stage liver disease (ESLD) and is associated with increased morbidity and mortality. The inability to accurately estimate energy needs of these patients may contribute to their poor nutrition status. In clinical practice, predictive equations are used to calculate resting energy expenditure (cREE). The objective of this study is to assess the accuracy of commonly used equations in pediatric patients with ESLD. Methods: Retrospective study performed at the Hospital for Sick Children. Clinical, laboratory, and indirect calorimetry data from children listed for liver transplant between February 2013 and December 2014 were reviewed. Calorimetry results were compared with cREE estimated using the Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU), Schofield [weight], and Schofield [weight and height] equations. Results: Forty‐five patients were included in this study. The median age was 9 months, and the most common indication for transplantation was biliary atresia (64%). The Schofield [weight and height], FAO/WHO/UNU, and Schofield [weight] equations were compared with indirect calorimetry and found to have a mean (SD) difference of 48.8 (344.0), 59.3 (229.8), and 206.5 (502.6) kcal/d, respectively. The FAO/WHO/UNU, Schofield [weight], and Schofield [weight and height] equations introduced a mean error of 21%, 38%, and 76%, respectively. The FAO/WHO/UNU equation tended to underestimate, whereas the Schofield equations overestimated the REE. Conclusions: Commonly used predictive equations perform poorly in infants and young children with ESLD. Indirect calorimetry should be used when available to guide energy provision, particularly in children who are already malnourished. 相似文献
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终末期肝病患者肝移植前后的能量代谢特点 总被引:1,自引:0,他引:1
目的探讨乙肝病毒感染终末期肝病患者肝移植前后能量代谢及碳水化合物、蛋白质、脂肪氧化供能的特点。方法采用间接测热法应用CCM/D营养代谢测试系统测定10例终末期肝病患者肝移植术前1周及术后4~6月内的静息能量消耗(REE)、晨起空腹呼吸商(RQ)及三大营养物质的氧化率,并比较肝移植前后的差别。结果10例终末期肝病患者术前REE为(5983.5±2238.4)kJ/24h,夜间禁食晨起空腹时RQ为0.84±0.05,碳水化合物、蛋白质、脂肪氧化率依次为(38.20±20.05)%、(24.40±22.53)%、(37.30±24.94)%。肝移植术后,REE为(5084.3±1266.6)kJ/24h,与术前比较差异无显著性(P=0.105),晨起空腹RQ(0.93±0.11)、碳水化合物氧化率[(66.60±35.48)%]和蛋白质氧化率[(66.60±35.48)%]均较术前升高,但差异无显著性(P>0.05);脂肪氧化率显著降低至(2.20±47.70)%(P=0.049)。结论终末期肝病患者处于低代谢状态,对糖类利用存在障碍,只能通过加强脂肪动员供能。随着新肝植入及肝功能恢复,患者体内对糖类利用增加,脂肪... 相似文献
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Impact of Disease Activity on Resting Energy Expenditure and Body Composition in Adult Crohn's Disease 下载免费PDF全文
Jianfeng Gong MD Lugen Zuo MD Zhen Guo MD Liang Zhang MD Yi Li MD Lili Gu MD Jie Zhao MD Lei Cao MD Weiming Zhu MD Ning Li MD Jieshou Li PhD 《JPEN. Journal of parenteral and enteral nutrition》2015,39(6):713-718
Background: There is controversy about nutrition status and calorie needs during phases of active versus inactive adult Crohn's disease (CD). Results have been reported in cross‐sectional studies, but longitudinal data are unavailable. Our aim was to explore whether disease activity had an impact on resting energy expenditure (REE) and body composition in adult patients with CD. Materials and Methods: Adult patients were studied on 2 occasions with active and inactive CD. REE was measured by indirect calorimetry. Body composition was estimated from bioelectrical impedance analysis. Disease activity was measured using the Crohn's Disease Activity Index (CDAI). Regression analyses of REE with CDAI score, C‐reactive protein, and erythrocyte sedimentation rate were also performed. Results: Seventy‐five patients were included. Patients with active CD had increased REE/body weight compared with patients with inactive disease (28.8 ± 5.4 vs 25.9 ± 4.3 kcal/kg, P < .001). Disease behavior and location, but not sex, had an impact on REE/body weight. Body mass index was lower in active disease than in remission (17.4 ± 3.0 vs 18.1 ± 2.6 kg/m2, P = .010). Body composition was not affected by disease behavior or location. Conclusion: Patients with remission had a better nutrition status and decreased REE compared with those with active CD. REE could also be affected by disease location and behavior. 相似文献
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目的观察风湿性心脏病瓣膜置换手术患者围体外循环期静息能量消耗的改变。方法将接受体外循环手术的风心病患者20例分为男、女两组,A组为男性,B组为女性。采用间接能量监测仪测定手术前后的静息能量消耗,手术前后构成自身对照。结果男性患者在术后第1、3、5、7天的静息能量消耗与术前的静息能量消耗之比分别为(1.346±0.004雪、穴1.158±0.001雪、穴1.091±0.001雪和穴0.992±0.001雪;女性患者为穴1.285±0.002雪、穴1.130±0.001雪、穴1.052±0.001雪和穴1.008±0.0003雪;术后前5天明显高于术前穴P<0.01雪,术后第7天与术前无显著性差异。手术对男女性患者静息能量消耗的影响在术后第1天有显著性差异。结论风心病瓣膜置换手术后能量消耗有一定程度的增高。 相似文献
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Rami Bou Khalil Ariane Sultan Maude Seneque Sami Richa Patrick Lefebvre Eric Renard Philippe Courtet Laurent Maimoun Sebastien Guillaume 《Nutrients》2022,14(13)
Resting energy expenditure (REE; i.e., the calorie amount required for 24 h during a non-active period) is an important parameter in nutritional rehabilitation of patients with anorexia nervosa (AN). This study determined whether age, body mass index, AN duration/subtype/specific symptoms/clinical severity, cognitive function alterations, and psychiatric comorbidities influenced REE or the difference between the calculated and estimated REE. Patients with AN who were followed at a daycare treatment facility between May 2017 and January 2020 (n = 138) underwent a complete assessment that included the MINI, Eating Disorder Examination Questionnaire, d2 test of attention, body fat composition by bioelectrical impedance analysis (BIA) and REE measurement by indirect calorimetry (REEIC). AN subtype (N = 66 for restrictive subtype and N = 69 for non-restrictive subtype; p = 0.005), free-fat mass (<0.001), and fat mass (<0.001) were associated with REEIC. Age (p < 0.001), height (p = 0.003), and AN duration (N = 46 for <3 years and N = 82 for ≥3 years; p = 0.012) were associated with the difference between estimated REE (using the Schebendach equation) and measured REEIC. Therefore, the Schebendach equation was adjusted differently in the two patients’ subgroups (AN duration ≤ or >3 years). Overall, REE was higher in patients with restrictive than non-restrictive AN. In the absence of BIA measures, REE-estimating equations should take into account AN duration. 相似文献