10例青春期神经性厌食病儿静息能量代谢测定分析初探

Analysis REE of 10 adolescent anorexia nervosa patients

目的 :探讨青春期儿童神经性厌食的营养治疗前静息能量代谢状况。方法 :收集2015.06~2017.06期间因神经性厌食住院及门诊病儿10例。营养治疗开始前进行静息能量代谢测定,并完成人体成分分析。同时根据临床常用的四种静息能量代谢公式进行能量需求的计算。Harris-Benedict公式(女):665+9.6×体质量(kg)+1.9×身高(cm)-4.7×年龄(岁);Schofield-HTWT公式(女):8.365×体质量(kg)+465.57×身高(m)+200.04;Katch-McArdle公式:BMR=370+[21.6×瘦体质量(kg)]; LIU公式:BMR=13.88×体质量(kg)+4.16×身高(cm)-3.43×年龄(岁)-112.40×性别(男=0,女=1)+54.34。结果 :本研究共收集病儿10例,均为青春期女孩,平均年龄(13.5±0.4)岁。代谢车测定结果 [(20.63±2.45) kcal/(kg·d)]均明显低于四种常用公式,H-B公式:(31.50±3.81)kcal/(kg·d),Schofield-HTWT公式:(34.03±3.84) kcal/(kg·d),Katch-Mc Ardle公式:(29.52±3.78)kcal/(kg·d),LIU公式:(31.31±2.67) kcal/(kg·d)计算得出的静息能量(P <0.001),代谢车测定结果占到公式测定结果的60%~70%。结论 :神经性厌食病儿静息能量代谢公式评估结果均明显高于代谢车测定结果,建议应用代谢车进行营养治疗。

Objective： To investigate the resting energy expenditure（REE） prior to nutritional therapy in Chinese Adolescence with Anorexia Nervosa（AN） patients. Method： From June 2015 to June 2017, 10 patients from inpatient and outpatient that were diagnosed with AN were recruited. REE was measured by the metabolic cart before nutrition therapy, and were calculated using the following 4 formulas ：Harris-Benedict（women）, 665 ＋ 9.6 × weight（kg） ＋1.9 ×height（cm）-4.7 × age（years）; Schofield-HTWT（women）, 8.365× weight（kg） ＋ 465.57 × height（m） ＋ 200.04; KatchMcArdle, BMR=370＋（21.6 × lean mass in kg）; LIU equation： BMR=13.88 × weight（kg） ＋ 4.16 × height（cm）-3.43 ×age（years）-112.40 × sex（man=0, woman=1） ＋54.34. Result： All of the 10 patients were adolescent girls aged（13.5 ±0.4） years. The results from metabolic cart [（20.63 ± 2.45） kcal/（kg·d）] were lower than the results of formulas, H-B：（31.50 ± 3.81） kcal/（kg · d）; Schoild：（34.03 ± 3.84） kcal/（kg · d）; K-M：（29.52 ± 3.78） kcal/（kg · d）; LIU：（31.31 ± 2.67） kcal/（kg · d）,（P 0.001）. Conclusion： Metabolic cart is necessary for REE calculation before nutrition therapy in adolescent AN patients.