慢性重型肝炎患者碳水化合物、蛋白质、脂肪氧化代谢监测  

Monitoring of the Oxidation Rates of Carbohydrate,Fat,and Proteins in Patients with Chronic Severe Hepatitis

作　　者：冯岩梅[1] 孟庆华[1] 于红卫[1] 李娟[1] 王金环[1] 王馨[1] 

机构地区：[1]首都医科大学附属北京佑安医院肝病四科,北京100069

出　　处：《中国临床营养杂志》2007年第5期276-280,共5页Chinese Journal of Clinical Nutrition

基　　金：北京市科委科技基金项目(H020920020890)

摘　　要：目的探讨慢性重型肝炎患者碳水化合物、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8例慢性重型肝炎患者夜间禁食与睡前加餐后晨起空腹及3餐后2小时的呼吸商(RQ)及24小时尿氮(微量凯式定氮法),监测静脉应用葡萄糖时的RQ。结果慢性重型肝炎患者夜间禁食晨起空腹时RQ为全天中最低(0.76±0.07),脂肪、蛋白质、碳水化合物氧化率依次为(63.88±31.60)%、(22.38±13.19)%、(13.75±23.64)%;睡前加餐RQ均提高,脂肪氧化率降低到(48.13±28.24)%,碳水化合物氧化率增加到(37.25±24.05)%,蛋白质氧化率降低到(14.75±10.73)%;静脉应用葡萄糖时可见RQ迅速提高。结论慢性重型肝炎患者晨起空腹时以脂肪、蛋白质为主要供能物质,睡前加餐及葡萄糖的静脉应用可提高碳水化合物的供能比例,节约脂肪、蛋白质。Objective To analyze the oxidation rates of carbohydrate, fat, and proteins in patients with chronic severe hepatitis. Methods Respiratory quotient （RQ） in 8 patients with chronic severe hepatitis was measured using indirect calorimetry after overnight fasting and at 7 ： 00 （ limosis）, 10 ： 00, 14 ： 00, and 19 ： 00. Af- ter the normal saline and 5 % glucose liquor were injected intravenously, RQ was dynamically measured again. Results The RQ early at the morning after overnight fasting was lowest among those measured at different time points. The oxidation rates of fat, proteia, and carbohydrate were （63.88 ± 31.60 ）%, （22.38 ± 13. 19）%, and （13.75 ±23.64）% , respectively, at this time paint. When meals were added before sleeping, RQ at different time points increased, the oxidation rate of fat decreased to （48. 13 ±28. 24）%, the oxidation rate of carbohydrate increased to （ 37.25 ± 24.05 ） %, and the oxidation rate of protein decreased to （ 14. 75 ± 10. 73 ） %. RQ rapidly increased after glucose was injected intravenously. Conclusions Fat and protein are the main source of energy in patients with chronic severe hepatitis early at the morning after overnight fasting. Meals before sleeping and intravenous administration of glucose may improve the oxidation rate of carbohydrate and optimize the usage of fat and protein.

关 键 词：慢性重型肝炎 呼吸商 

分 类 号：R575.1[医药卫生—消化系统]