合并自发性细菌性腹膜炎对男性酒精性肝硬化患者能量代谢的影响  

Effect of spontaneous bacterial peritonitis on energy metabolism in male patients with alcoholic liver cirrhosis

作　　者：赵娟[1] 苏璇 徐斌[1] Zhao Juan;Su Xuan;Xu Bin(Department of Second Liver Disease Centre,Beijing You'an 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,100069

出　　处：《北京医学》2024年第10期815-819,共5页Beijing Medical Journal

基　　金：首都医科大学附属北京佑安医院人才库培养计划(YARCKB2023001)。

摘　　要：目的探讨合并自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)对男性酒精性肝硬化(alcoholic liver cirrhosis,ALC)患者能量代谢的影响。方法选取2018年1月至2023年6月首都医科大学附属北京佑安医院男性ALC患者85例,根据是否合并SBP分为SBP组(n=34)和无SBP组(n=51)。对所有患者进行间接能量代谢测定,收集能量代谢指标,包括实测静息能量消耗(resting energy expenditure,REE)、预测静息能量消耗(predict resting energy expenditure,pREE)、呼吸商(respiratory quotient,RQ)、碳水化合物氧化率(carbohydrate oxidation rate,CHO%)、脂肪氧化率(fat oxidation rate,FAT%)及蛋白质氧化率(protein oxidation rate,PRO%),并对患者进行血常规及肝功能测定。比较两组ALT、AST、T-BIL、ALB、REE、pREE、REE/pREE、RQ、CHO%、FAT%及PRO%,采用单因素分差分析比较无腹水组、少量腹水组、中量腹水组及大量腹水组REE、pREE、REE/pREE、RQ、CHO%、FAT%及PRO%。结果85例ALC患者年龄30~63岁,平均(51.5±7.8)岁。SBP组ALB[(30.93±5.49)g/L比(34.00±5.42)g/L]、前白蛋白[(102.13±39.60)g/L比(136.00±67.65)g/L]、Hb[(105.47±24.44)g/L比(117.76±26.17)g/L]低于无SBP组;SBP组REE/pREE[(106.00±16.37)%比(95.41±13.00)%]、FAT%[(50.59±14.92)%比(44.20±12.13)%]高于无SBP组,RQ[(0.78±0.05比0.80±0.05)]低于无SBP组;大量腹水组REE/pREE高于少量腹水组、中量腹水组[(107.57±17.11)%比(96.46±14.98)%、(96.73±13.93)%],差异均有统计学意义(P<0.05)。结论SBP及腹水量均可影响ALC患者的能量代谢,合并SBP可提高ALC患者的REE/pREE及FAT%,降低RQ值。Objective To explore the influence of spontaneous bacterial peritonitis(SBP)on the energy metabolism of male patients with alcoholic liver cirrhosis(ALC).Methods A total of 85 male ALC patients in Beijing You'an Hospital,Capital Medical University from January 2018 to June 2023 were selected,and were divided into the SBP group(n=34)and the non-SBP group(n=51)based on the presence or absence of SBP.Indirect energy metabolism was measured for all patients,and energy metabolism indicators were collected,including resting energy expenditure(REE),predicted resting energy expenditure(pREE),respiratory quotient(RQ),carbohydrate oxidation rate(CHO%),fat oxidation rate(FAT%),and protein oxidation rate(PRO%).Blood routine tests and liver function tests were conducted for all patients.The levels of ALT,AST,T-BIL,ALB,REE,pREE,REE/pREE,RQ,CHO%,FAT%,and PRO%were compared between the two groups.The REE,pREE,REE/pREE,RQ,CHO%,FAT%,and PRO%were compared among the groups without ascites,with a small amount of ascites,with a moderate amount of ascites,and with a large amount of ascites by one-way analysis of variance.Results The 85 patients with ALC ranged in age from 30 to 63 years,with an average age of(51.5±7.8)years.The levels of ALB[(30.93±5.49)g/L vs.(34.00±5.42)g/L],prealbumin[(102.13±39.60)g/L vs.(136.00±67.65)g/L],and Hb[(105.47±24.44)g/L vs.(117.76±26.17)g/L]in the SBP group were lower than those in the non-SBP group.The REE/pREE[(106.00±16.37)%vs.(95.41±13.00)%]and FAT%[(50.59±14.92)%vs.(44.20±12.13)%]in the SBP group were higher than those in the non-SBP group,while the RQ[(0.78±0.05)vs.(0.80±0.05)]was lower than that in the non-SBP group.The REE/pREE in the large amount of ascites group was higher than those in the small and moderate amount of ascites groups[(107.57±17.11)%vs.(96.46±14.98)%,(96.73±13.93)%],and the differences were statistically significant(P<0.05).Conclusions Both SBP and the amount of ascites can affect the energy metabolism of ALC patients.SBP can increase the REE/pREE and FAT%and decr

关 键 词：酒精性肝硬化 自发性细菌性腹膜炎 腹水 静息能量消耗 

分 类 号：R575.2[医药卫生—消化系统] R572.2[医药卫生—内科学]