机械通气危重症患儿静息能量消耗与营养评估指标相关性分析  

Correlation analysis between resting energy expenditure and nutritional assessment indicators in critically ill children with mechanical ventilation

作　　者：陈晖[1] 纪健[1] 钱素云[1] Chen Hui;Ji Jian;Qian Suyun(Department of Pediatric Intensive Care Unit,National Center for Children′s Health,Beijing Children′s Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院儿童重症医学科,100045

出　　处：《中华实用儿科临床杂志》2021年第1期42-45,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：儿科临床营养科研基金项目(NST-FUND-2014-09);北京市外籍高层次人才资助计划(PICU质量管理与院感防控建设项目)(Z201910)。

摘　　要：目的了解机械通气患儿的静息能量消耗情况,分析其与人体测量学指标(身高、体质量、体质量指数)和血清蛋白学指标(前白蛋白、白蛋白、转铁蛋白、视黄醇结合蛋白)的相关性。方法以2015年8月至2016年4月入住首都医科大学附属北京儿童医院儿童重症监护病房(PICU)的机械通气患儿为研究对象。入选标准:(1)小儿危重病例评分<90分,或符合美国PICU入院标准;(2)29 d<年龄<18岁;(3)机械通气治疗时间>24 h;(4)机械通气潮气量>60 mL。在患儿接受机械通气的15~24 h采用美国麦加菲Med Graphic公司CCM/D能量代谢测定系统测量患儿静息能量消耗情况、德国Famed Zywier重症监护床自带体质量秤称量体质量、统一量床或米尺测量身高、全自动生化分析仪及放射免疫扩散法测定白蛋白、前白蛋白、转铁蛋白、视黄醇结合蛋白。采用SPSS 20.0软件进行Pearson直线分析相关性。结果共有68例患儿纳入研究,其中男36例,女32例,体质量(22.34±14.89)kg;身高(122.23±14.89)cm。静息能量消耗水平(784.63±278.25)kcal(1 kcal=4.185 kJ),每公斤体质量静息能量消耗(48.80±31.26)kcal。人体测量学指标中,静息能量消耗与身高、体质量均呈显著正相关(r=0.764、0.734,均P<0.05),与体质量指数呈低度正相关(r=0.396,P<0.05);血清蛋白组学中,静息能量消耗与前白蛋白、转铁蛋白均呈低度负相关(r=-0.318、-0.282,均P<0.05)、与视黄醇蛋白呈中度负相关(r=-0.505,P<0.05),与白蛋白无相关性(r=-0.075,P>0.05)。结论机械通气危重症患儿的身高、体质量、血清蛋白组学各项指标可能影响静息能量消耗。Objective To investigate the resting energy expenditure of children with mechanical ventilation and analyze their association with anthropometric indicators(height,weight,and body mass index)and serum protein markers(pre-albumin,albumin,transferrin,and retinol).Methods An observational study was held in Pediatric Intensive Care Unit(PICU)of Beijing Children′s Hospital,Capital Medical University,from August 2015 to April 2016.Critically ill children with mechanical ventilation were enrolled in this study.Inclusion criteria were as follows:(1)pediatric critical illness score<90 scores or meet the United States PICU admission criteria;(2)age>29 days,<18 years old;(3)mechanical ventilation>24 hours;(4)tidal volume>60 mL.Resting energy expenditure was determined by US Med Graphic Company CCM/D energy metabolism test system.German Famed Zywier intensive care bed with weight scale weighing,uniform measuring bed or meter measuring height,automatic biochemical analyzer and radioimmunoassay was adopted for the determination of albumin,pre-albumin,transferrin,retinol binding protein.SPSS 20.0 software was applied for carrying out Pearson line analysis correlation.Results A total of 68 children were included in the study,including 36 males and 32 females,body weight(22.34±14.89)kg,height(122.23±14.89)cm,resting energy consumption(784.63±278.25)kcal(1 kcal=4.185 kJ),and resting energy consumption per kilogram of body weight(48.80±31.26)kcal.In anthropometric indicators,resting energy expenditure was significantly positively correlated with height,body weight(r=0.764,0.734,all P<0.05),a low positive correlation with body mass index(r=0.396,P<0.05).In serum proteomics,resting energy expenditure was negatively correlated with pre-albumin,transferrin(r=-0.318,-0.282,all P<0.05),and a moderate negative correlation with retinol protein(r=-0.505,P<0.05),while without correlation with albumin(r=-0.075,P>0.05).Conclusions The height,weight and serum proteomics of children with mechanical ventilation may affect resting energy exp

关 键 词：机械通气 静息能量消耗 儿童 营养评估 

分 类 号：R720.597[医药卫生—急诊医学]