能量估测公式评估短肠综合征患者静息能量消耗的研究

目的 研究目前常用的4种能量消耗估测公式在评估短肠综合征患者静息能量消耗(REE)时的准确性以及静息能量消耗与人体成分指标的相关性.方法 以2001年1月至2010年10月收治的短肠综合征患者为研究对象.全部病例41例,其中男性30例,女性11例;年龄18～60岁,平均(37±16)岁;平均身高(164.3 ±9.0)cm;平均体质量(47.0±9.3)kg;平均残余小肠(52±45)cm.所有患者均需要行长期肠外或肠内加肠外营养支持治疗.采用间接能量代谢检测仪检测患者REE,同时使用目前常用的4种REE估测公式(HB、SR、FAO、LIU)对患者进行REE估测,并评价两者间差异.利用人体成分分析仪对患者进行身体成分分析.结果 全部患者实测REE的平均值为(1218 ±293)Kcal,与4种计算公式估测REE值均有相关性,相关系数分别为:HB(r=0.588,P<0.01),SR(r=0.591,P<0.01),FAO(r=0.411,P<0.01),LIU(r=0.585,P<0.01).实测REE和4种估测REE进行配对t检验的结果 显示,在总样本中,实测REE值与HB、SR和FAO公式估测值的差异无统计学意义(均P<0.05),但比LIU公式估测值高出14.17%(P<0.01).实测REE与体质量、无脂体质量、体细胞总体有显著相关性,相关系数分别为0.548、0.641和0.581.结论 评估短肠综合征患者REE时应首选间接能量代谢检测仪,在没有条件使用该检测仪而需利用估测公式评估时,应尽量避免使用LIU公式,而应选择SR公式进行评估.短肠综合征患者的REE与体质量、无脂体质量、体细胞总体均有相关性,其中无脂体质量的相关性最高.

Abstract：

Objectives To determine the accuracy of resting energy expenditure (REE) calculated by using the Harris-Benedict(HB) equation, Food and Agriculture Organization/World Health Organization/ United Nations University (FAO/WHO/UNU) equations (FAO equations) , Shizgal-Rosa (SR) equation and the LIU equation in patients with short bowel syndrome(SBS). In addition, to explore the relationship between measured REE and body weight, fat free mass, body cell mass, fat mass and fat mass percent. Methods Fourty-one SBS patients including 30 male and 11 female, aged from 18 to 60 years admitted between January 2001 and October 2010 were enrolled in this study. All patients required long-term parenteral or enteral plus parenteral nutrition support Their mean age and mean stature were (37 ± 16) years and (164. 3 ± 9. 0) cm, and the average body weight and residual small intestine was (47.4 ± 9. 3) kg and (52 ±45) cm. Measured REEs and calculated REEs of SBS patients were estimated respectively by indirect calorimetry and REE equations, and then defined the difference of them. And body mass were metered by body composition analyzer. Results A significant correlation was found between measured REEs (1218 ± 293) Kcal and calculated REEs from the HB equation (r = 0. 588, P < 0.01), the SR equations (r = 0.591,P<0.01), the FAO equations (r=0.411 ,P<0.01) and the LIU equation (r=0.585,P<0.01).In the total sample, the paired t test between measured REEs and REEs derived from the HB equation,SR equation and FAO equation showed no significant difference (P > 0. 05). However, measured REEs were significantly higher than REEs calculated using the LIU equations by 14. 17% (P <0. 01). There was also a significant correlation between measured REEs and body weight, fat free mass and body cell mass (r = 0. 548,0. 641 and 0. 581). Conclusions Indirect calorimetry is preferred when an accurate REE estimate of SBS patients is necessary. However, if this machine is not available, SR equation is recommended to use and LIU equation must be avoided. Fat free mass may be more useful than body weight in REE calculation.

The study of resting energy expenditure equation for short bowel syndrome patients

Objectives To determine the accuracy of resting energy expenditure (REE) calculated by using the Harris-Benedict(HB) equation, Food and Agriculture Organization/World Health Organization/ United Nations University (FAO/WHO/UNU) equations (FAO equations) , Shizgal-Rosa (SR) equation and the LIU equation in patients with short bowel syndrome(SBS). In addition, to explore the relationship between measured REE and body weight, fat free mass, body cell mass, fat mass and fat mass percent. Methods Fourty-one SBS patients including 30 male and 11 female, aged from 18 to 60 years admitted between January 2001 and October 2010 were enrolled in this study. All patients required long-term parenteral or enteral plus parenteral nutrition support Their mean age and mean stature were (37 ± 16) years and (164. 3 ± 9. 0) cm, and the average body weight and residual small intestine was (47.4 ± 9. 3) kg and (52 ±45) cm. Measured REEs and calculated REEs of SBS patients were estimated respectively by indirect calorimetry and REE equations, and then defined the difference of them. And body mass were metered by body composition analyzer. Results A significant correlation was found between measured REEs (1218 ± 293) Kcal and calculated REEs from the HB equation (r = 0. 588, P < 0.01), the SR equations (r = 0.591,P<0.01), the FAO equations (r=0.411 ,P<0.01) and the LIU equation (r=0.585,P<0.01).In the total sample, the paired t test between measured REEs and REEs derived from the HB equation,SR equation and FAO equation showed no significant difference (P > 0. 05). However, measured REEs were significantly higher than REEs calculated using the LIU equations by 14. 17% (P <0. 01). There was also a significant correlation between measured REEs and body weight, fat free mass and body cell mass (r = 0. 548,0. 641 and 0. 581). Conclusions Indirect calorimetry is preferred when an accurate REE estimate of SBS patients is necessary. However, if this machine is not available, SR equation is recommended to use and LIU equation must be avoided. Fat free mass may be more useful than body weight in REE calculation.