恶性肿瘤病人能量消耗及机体组成变化测定

Assessment of energy expenditure and body composition in cancer patients

目的测定恶性肿瘤病人静息能量消耗(REE)、底物氧化及机体组成,探讨能量消耗与底物代谢的关系。方法间接测热法测定复旦大学附属中山医院2006年9月至2008年3月714例恶性肿瘤病人和642例良性疾病对照人群REE、碳水化合物氧化率(CO)、脂肪氧化率(FO)。生物电阻抗法测定细胞内水(ICF)、细胞外水(ECF)、总体水(TW)、脂肪群(FM)、非脂肪群(FFM)。结果恶性肿瘤组与对照组相比,mREE/FFM和mREE/PEE升高;处于较高的能量消耗分布状态;FO升高,CO和npRQ降低;ECF/BW和TW/BW增加,ICF/BW减少;FM和FFM减少,以FM减少为主;BCM减少。结论恶性肿瘤病人总体上具有较高的能量消耗;FO升高,CO和npRQ降低;FM和FFM减少,BCM丢失。ECF/BW和TW/BW增加、ICF/BW减少;能量消耗增加与底物代谢变化有一定关系。

Objective To assess the alternations of resting energy expenditure ,fuel utilization, and body composition in cancer patients, and to establish if there is a relationship between REE and fuel utilization. Methods REE, C-O and F-O of 714 cancer patients and 642 control subjects admitted between September 2006 and March 2008 at Zhongshan Hospi- tal of Fudan University were measured by indirect calorimetry. ECF, ICF and TW were measured by bioelectrieal impedance appliance, and FM, FFM were further determined. Results Compared with the controls, cancer patients showed higher mREE/FFM and mREE/PEE. They were at a higher energy consumption status. Cancer patients showed higher F-O,lower C-O and npRQ, higher ECF,lower ICF, higher TW/BW and ECF/BW,lower ICF/BW. Cancer patients exhibited lower FM, FM/BW and FFM, higher FFM/BW, and lower BCM. Conclusion Cancer patients exhibit a wide energy distribution and have elevated energy expenditure in general. Cancer type, pathological stage and duration of disease are potentially important determinants of REE. Cancer patients had increased F-O, decreased C-O and npRQ, which is correlative with the elevated REE. FM and FFM lose in parallel in cancer patients. BCM diminishes in cancer patients. Increased TW/BW and ECF/BW, decreased ICF/BW is found in cancer patients.