不同BMI组危重患者能量需求的Harris-Benedict公式估算法

Effects of BMI on the estimation of the energy metabolism of critically ill patients by Harris-Benedict equation

目的探究Harris-Benedict(HB)公式用于估算机械通气的危重症患者能量代谢的准确性,以及不同BMI分组对其影响。方法使用间接能量测定法测量患者的静息能量(ICREE),通过HB公式计算其静息能量代谢估算值(HBREE)。将80例患者按BMI分为4组,并通过配对样本t检验对ICREE与HBREE进行比较,Pearson分析用于分析ICREE与HBREE的相关性。结果共纳入80例机械通气的危重症患者。除肥胖组外的其余各组病人,ICREE均高于HBREE(均P<0.01),HB公式的准确率为23.75%。ICREE与HBREE相关性差(r=0.331,P<0.01)。当各组使用校正系数对HB公式进行调整后,ICREE与HBREE差异无统计学意义,准确率提高至38.8%。结论使用HB公式不能很好地反应危重症患者的实际能量代谢。BMI可能是影响HB公式准确性的重要因素。依据不同BMI分组,使用相应校正系数可提高HB公式的准确性。

Objective To explore the accuracy of the Harris-Benedict(HB)formula used to estimate the energy metabolism in critically ill patients undergoing mechanical ventilation and the effects of different BMI groups on it.Methods Indirect calorimetry was used to measure the resting energy of the patient,and the estimated resting energy metabolism was calculated by the HB formula.80 patients were divided into four groups according to BMI.ICREE and HBREE were compared by paired sample t test.Pearson analysis was used to analyze the correlation between ICREE and HBREE.Results This study included 80 critically ill patients undergoing mechanical ventilation.Except for the obese group,ICREEE was higher than HBREE in all patients and the remaining groups of patients.The accuracy rate of the HB formula was 23.75%.The correlation between ICREE and HBREE is poor(r=0.331,P<0.01).There was no statistical difference between ICREEE and HBREE and the accuracy rate increased to 38.8%after the Harris-Benedict equation was adjusted by using the correction factor.Conclusion Using the HB formula can not reflect the actual energy metabolism of critically ill patients well.BMI may be an important factor affecting the accuracy of HB formula.The accuracy of the HB equation can be improved by using different correction factors according to different BMI groupings.