高龄老年患者静息能量代谢实测值与预计值的一致性分析

Study on the Agreement of Indirect Calorimetry and Mathematical Formulas in Assessing the Values of Resting Energy Expenditure

目的：间接测热法是评估能量代谢的金标准，但目前仍常用公式法预测能量代谢。本研究评估间接测热法与公式法在评估高龄老年患者静息能量代谢值时的一致性。方法：入选11例85岁以上老年患者，平均年龄（89．78±6．25）岁，采用间接测热法测量患者实际的静息能量代谢值（Resting energy expenditure，REE），同时使用3个常用的REE预测公式计算该患者的REE值，使用Spearman相关、Bland—Altman分析法以及吻合比例分析两种结果的一致性。结果：实测REE值是（956．36±254．38）kcal／d。3个评价公式的预测值与实测值均呈正相关（P〈0．05）。使用Bland—Ahman分析法计算95％一致性界限时，符合率较高，但离散值较大。结论：在评估高龄老年患者的静息能量代谢时，公式预测法并不可靠，建议直接使用间接测热法进行实测。

OBJECTIVE ： To study the agreement of indirect calorimetry （IC） and mathematical formulas in assessing predictive value of resting energy expenditure （REE） in old - old patients. METHODS ： The study included 11 old - old patients （ age 89.78 ± 6. 25 years）. Number range of REE was measured by IC in all patients as a standard procedure. And simultaneously 3 distinct predictive equations, Bland - Airman plots and regression analysis were used to assess the agreement between measured and calculated REE. RESULTS ： Measured REE was （956. 36 ± 254. 38 ） kcal/d. Calculated values were correlated positively with IC - derived measurements. When Bland - Altman method was used to calculate the 95% limits of agreement were too wide to be accepted clinically. CONCLUSION ： In old - old adult patients, measured REE is poorly correlated with calculated values. The result of study in this paper shows that it is necessary to use IC to measure the value of REE.