酒精性肝硬化病人能量代谢和临床特点

Energy metabolism and clinical features in patients with alcoholic cirrhosis

目的:探讨酒精性肝硬化病人能量代谢和临床特点。方法:设酒精性肝硬化病人为研究组(酒精组),乙肝肝硬化病人为对照组(乙肝组),每组各30例。根据肝功能进行Child-Pugh分级,应用Med Graphic CCM/D营养代谢测试系统进行能量代谢测定。结果:两组病人实测静息能量消耗(REE)与REE预计值的比值均<90%。酒精组病人的呼吸商(RQ)低于乙肝组,脂肪氧化率(FAT)%高于乙肝组,蛋白质氧化率(PRO)%低于乙肝组,差异均有统计学意义(P<0.01)。随着Child-Pugh分级由A级至C级,FAT%和PRO%逐渐升高,两组均伴随糖类氧化率(CHO)%和RQ值逐渐降低。相同Child-Pugh分级,酒精组FAT%高于乙肝组,而PRO%却低于乙肝组。结论:酒精性肝硬化病人为低代谢状态,代谢率随肝功能Child-Pugh分级发生动态变化。其突出表现为:1RQ值降低更明显;2糖利用障碍;3能量和物质代谢异常随Child-Pugh由A级至C级更突出。

Objective：To investigate the energy metabolism and clinical features in patients with alcoholic cirrhosis.Methods：60 patients were divided into two groups,30 cases of alcoholic cirrhosis as the study group （alcohol group）,30 cases of hepatitis B liver cirrhosis patients as the control group （hepatitis B group）.Indirect calorimetry was applied to detect the indexes of energy metabolism for two groups.Results：The ratios of measured REE and predict REE were ＜ 90％ in two groups.RQ values and PRO％ in alcohol group were lower than that of hepatitis B group,but FAT％ was higher,and the difference was statistically significant （P ＜ 0.01）.With Child-Pugh A to C,FAT％ and PRO％ gradually increased in both groups,and CHO％ and RQ values decreased.In the alcohol group,FAT％ was higher than that in the hepatitis B group,while PRO％ was lower than that in the hepatitis B group.Conclusion：Alcoholic cirrhosis is of low metabolic state.RQ value decreases,fat is the main material for energy,and the metabolism abnormalities is prominent.