原发性胆汁性胆管炎病人能量代谢特点研究  

Characteristics of energy metabolism in patients with primary biliary cholangitis

作　　者：赵娟[1] 魏琳琳[1] 徐斌[1] ZHAO Juan;WEI Lin-lin;XU Bin(Second Department of Liver Disease Centre,Beijing YouAn Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院肝病中心二科,北京100069

出　　处：《肠外与肠内营养》2021年第6期338-341,346,共5页Parenteral & Enteral Nutrition

基　　金：中国初级卫生保健基金会-佑安肝病艾滋病基金2018年度院内中青年人才孵育项目(YNKTQN20180208)。

摘　　要：目的:探讨原发性胆汁性胆管炎(PBC)病人能量代谢特点。方法:选取2016年5月至2019年4月首都医科大学附属北京佑安医院肝病科收治的33例PBC病人为研究对象,同时以11例健康体检者为对照。采用间接能量代谢测定仪进行两组能量代谢相关指标测定,包括实测静息能量消耗(REE)、预测REE(pREE)、呼吸商(RQ)、碳水化合物氧化率(CHO%)、蛋白质氧化率(PRO%)及脂肪氧化率(FAT%)。结果:PBC组REE显著低于健康对照组[(1110.67±289.43)kcal/d vs(1410.00±272.07)kcal/d,P=0.004]。PBC组REE/pREE(%)为(85.55±20.83)%,呈低代谢状态,显著低于健康对照组(P=0.015)。PBC组RQ显著低于健康对照组[(0.82±0.06)vs(0.87±0.04),P=0.001]。PBC组CHO%显著低于健康对照组(P=0.001),FAT%显著高于健康对照组(P=0.006),PRO%显著高于健康对照组(P=0.005)。与Child-Pugh A级及Child-Pugh B级病人相比,Child-Pugh C级病人REE/pREE(%)最低,为(76.67±7.37)%,低代谢状态更为显著。Child-Pugh B级及C级RQ值及CHO%显著低于Child-Pugh A级,营养物质代谢紊乱更为突出。结论:PBC病人实测REE偏低,呈低代谢状态,存在营养物质代谢紊乱,与肝损伤程度相关,需注意制定适宜的营养支持方案。Objective:To evaluate the characteristics of energy metabolism in patients with primary biliary cholangitis(PBC).Methods:From May 2016 to April 2019,thirty-three patients with PBC were enrolled in the department of hepatology in Beijing YouAn Hospital affiliated to Capital Medical University.Eleven healthy control subjects were also recruited in the study.Energy metabolism indexes were measured,including resting energy expenditure(REE),predict resting energy expenditure(pREE),respiratory quotient(RQ),and carbohydrate oxidation rate(CHO%),protein oxidation rate(PRO%)and fat oxidation rate(FAT%).Results:REE in the PBC group was(1110.67±289.43)kcal/day,which was significantly lower than that in the control group(1410.00±272.07)kcal/day,P=0.004.REE/pREE(%)in the PBC group was(85.55±20.83)%,which was significantly lower than in the control group(P=0.015).RQ in the PBC group was significantly lower than that in the control group[(0.82±0.06)vs(0.87±0.04),P=0.001].PBC group had decreased CHO%(P=0.001),higher levels of FAT%(P=0.006)and PRO%(P=0.005)compared with control group.REE/pREE(%)in PBC patients with Child-pugh grade C was the lowest,which was(76.67±7.37)%,and these patients had the significant low metabolic status.RQ and CHO%in Child-pugh grade B and C were significantly lower than that in grade A,and the metabolic disorder was more prominent.Conclusion:The measured REE in PBC patients is low,showing a low metabolic state and disorder of nutrient metabolism,which is related to the degree of liver injury.It is necessary to formulate an appropriate nutritional support program.

关 键 词：原发性胆汁性胆管炎 静息能量消耗 呼吸商 营养 

分 类 号：R575[医药卫生—消化系统]