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目的:比较代谢车(CCM)监测静息能量消耗(REE)与Harris-Benedict(HB)公式计算的基础能量消耗(BEE)在慢性阻塞性肺疾病(COPD)患者营养支持治疗中的应用价值。方法:选择诊断符合中华医学会呼吸病学分会制定的COPD诊治指南及微型营养评定法(MNA)评定为营养不良的57例COPD住院患者。将研究对象随机分为两组,分别按代谢车监测的静息能量消耗及HB公式计算的基础能量消耗计算每日能量需求后进行营养支持治疗,于第1天、第10天测定COPD患者吸气开始0.1 s时口腔阻断压(P0.1)、口腔最大吸气压(Pimax)、口腔最大呼气压(Pemax)、1 s用力呼气容积(FEV1)占预计值百分比(FEV1%)、最大通气量(MVV)占预计值百分比(MVV%)、动脉血二氧化碳分压(PaCO2)、血清白蛋白(Alb)、血清转铁蛋白(TF)、血清前白蛋白(PAlb)。结果:依据HB公式计算的每日能量需求与代谢车测量的每日能量需求比较,HB公式组较代谢车组高出约13.6%,差异有统计学意义(P<0.05);两组常规并营养支持治疗后P0.1、PaCO2值均下降,Pimax、Pemax、Alb、TF、PAlb值均增高(P<0.05),而FEV1%、MVV%无明显变化(P>0.05);代谢车组比HB公式组血清前白蛋白(PAlb)增加明显(P<0.05),其余各指标差异均无统计学意义(P>0.05)。结论:按代谢车监测的静息能量消耗计算的每日能量需求更接近患者的实际能量消耗,但代谢车与HB公式两种方法在COPD患者中营养支持效果无明显区别。
OBJECTIVE: To compare the value of basic energy expenditure (BEE) calculated by the metabolic motor vehicle (CCM) monitoring resting energy expenditure (REE) with Harris-Benedict (HB) formula in the nutritional support of patients with chronic obstructive pulmonary disease (COPD). Methods: Fifty-seven patients with COPD who were malnourished were selected according to the guidelines of diagnosis and treatment of COPD developed by the Chinese Society of Respiratory Diseases and the Mini-Nutrition Assessment (MNA). The subjects were randomly divided into two groups, respectively, according to metabolic car monitoring of resting energy consumption and HB formula to calculate the basic energy consumption calculation of daily energy requirements for nutritional support treatment, measured in the first day, the 10th day of COPD patients suck Oral occlusion pressure (P0.1), Pimax, Pemax and FEV1 percentage of predicted value (FEV1% (MVV%), PaCO2, Alb, TF and PAlb were measured. Results: The daily energy requirement calculated by HB formula was 13.6% higher than that of metabolic vehicle group (P <0.05), compared with the daily energy requirement of metabolic vehicle measurement (P <0.05) The values of P0.1 and PaCO2 decreased, the values of Pimax, Pemax, Alb, TF and PAlb increased (P <0.05), while the changes of FEV1% and MVV% had no significant changes (P> 0.05) HB pre-serum albumin (PAlb) increased significantly (P <0.05), the remaining indicators showed no significant difference (P> 0.05). CONCLUSION: The daily energy requirement calculated by the resting energy consumption monitored by the metabolic car is closer to the actual energy consumption of the patients. However, there is no significant difference between the metabolic car and the HB formula in the nutritional support effect of COPD patients.