间接测热法测定并比较不同疾病机械通气患者的静息能量消耗  

Resting expenditure energy in mechanically ventilated patients with different diseases measured by indirect calorimetry

作　　者：饶志勇[1] 胡雯[1] 袁红[1] 梁斌苗[2] 王茂筠[2] 

机构地区：[1]四川大学华西医院营养科,四川省成都市610041 [2]四川大学华西医院呼吸科,四川省成都市610041

出　　处：《中国组织工程研究与临床康复》2007年第44期8912-8915,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:传统的公式计算不能客观、正确地评定疾病状况下的能量消耗,所以利用间接测热法测定并分析机械通气的慢性阻塞性肺疾病患者与其他机械通气患者的静息能量消耗特点,并进行相关因素探讨。方法:于2007-02/07,用美国Med Graphic公司CCM/D能量代谢测试系统测定华西医院ICU病房的21例慢性阻塞性肺疾病和24例非慢性阻塞性肺疾病的机械通气患者静息能量消耗,并比较其差异,观察血浆白蛋白、动脉血氧分压、动脉血二氧化碳分压和全天能量供给与静息能量消耗和呼吸商的相关性。结果:45例患者进入结果分析。①慢性阻塞性肺疾病患者静息能量消耗高于非慢性阻塞性肺疾病患者(P<0.05),而两组患者的呼吸商比较差异无显著性意义(P>0.05)。②静息能量消耗和呼吸商与白蛋白、动脉血氧分压、动脉血二氧化碳分压均无明显相关性(P>0.05),呼吸商与全天能量供给存在显著的相关性(P<0.05),但静息能量消耗与全天能量供给无明显相关性。结论:机械通气患者中,慢性阻塞性肺疾病患者的静息能量消耗比其他机械通气患者高,全天能量供给对呼吸商有影响,但不能用呼吸商指导营养支持。AIM： Traditional formula calculation could not evaluate the energy expenditure in patients under disease objectively and correctly. So, in this study, the indirect calorimetry was used to investigate and analyze the characteristics of resting energy expenditure in mechanically ventilated patients with chronic obstructive pulmonary disease （COPD） and other mechanically ventilated patients, and the related factors were explored. METHODS： From February to July 2007, the resting energy expenditure between 21 mechanically ventilated patients with COPD and 24 mechanically ventilated patients in ICU ward of West China Hospital undergoing indirect calorimetry （CCM/D calorimetric system, Co. Med Graphic, USA） were compared. Albumin, arterial oxygen pressure （PO2）, partial pressure of carbon dioxide （PCO2） and the correlation of total energy supply with the resting energy expenditure and respiratory quotient were observed. RESULTS： All 45 patients were involved in the result analysis. ①The resting energy expenditure of the COPD patients was higher than that of the others （P 〈 0.05）, while there was no difference in respiratory quotient （P 〉 0.05）. ②There was no distinct correlation between resting energy expenditure, respiratory quotient, albumin, PO2 and PCO2 （P 〉 0.05）; significant correlation was found between respiratory quotient and total energy supply （P 〈 0.05）, but no obvious correlation between resting energy expenditure and total energy supply. CONCLUSION： In the mechanically ventilated patients, the resting energy expenditure of COPD patients is higher than that of the others; total energy supply could influence the respiratory quotient, but respiratory quotient cannot directly guide nutrition support.

关 键 词：静息能量消耗 代谢车 机械通气 慢性阻塞性肺疾病 

分 类 号：R318[医药卫生—生物医学工程]