脑出血术后静息代谢能量消耗实测值与H-B公式预计值对比研究

Comparative study between resting metabolic energy expenditure actual measurement value and H-B formula predictive value after cerebral hemorrhage operation

目的比较脑出血术后患者实际静息代谢能量消耗(REE)与Harris-Benedict(H-B)公式计算预计值的差异,并分析其影响因素,为合理的临床营养支持提供依据。方法选取2016年1月至2020年1月收治的165例脑出血患者,术后第3~5天分别采用代谢车(间接测热法)、H-B公式测定和推测REE,分析患者感染、体重指数(BMI)、年龄、性别与REE的关系。结果REE实测值明显高于预计值[(1654.6±484.0)kcal vs.(1498.6±215.9)kcal,P<0.05]。组内比较:感染组实测值明显高于预计值(P<0.05),男性组实测值明显高于预计值(P<0.05),女性组无明显差异(P>0.05);体质消瘦组和正常组实测值明显高于预计值(P<0.05),超重和肥胖组无明显差异(P>0.05);41~<51岁组、51~<61岁组、61~<71岁组实测值明显高于预计值(P<0.05),其余年龄组均无明显差异(P>0.05)。线性回归分析:实测值与性别、年龄相关(P<0.05),预计值与性别、年龄、BMI相关(P<0.05)。结论脑出血术后患者采用H-B公式计算的REE与代谢车实测值差异较大,建议以代谢车测定的REE值指导患者个体化营养治疗。

Objective To compare the difference between the actual resting energy expenditure(REE)value and the predictive value calculated by Harris-Benedict(H-B)formula in postoperative patients with cerebral hemorrhage,and to analyze its influencing factors to provide a basis for rational clinical nutrition support.Methods A total of 165 patients with cerebral hemorrhage from January 2016 to January 2020 were selected.REE was determined and speculated by adopting the metabolic cart(indirect calorimetry)and H-B formula on postoperative 3-5 d respectively.The relationships of REE to infection,body mass index(BMI),age and gender were analyzed.Results The actual REE value was significantly higher than the predicted REE value[(1654.6±484.0)kcal vs.(1498.6±215.9)kcal,P<0.05].Intra-group comparison:the actual measurement REE value in the infection group was significantly higher than the predicted REE value(P<0.05),the actual measurement REE value in the male group was markedly higher than the predicted REE value(P<0.05),while there was no significant difference in the female group(P>0.05);the actual measurement REE value in the physique thin group and normal group were apparently higher than the predicted REE value(P<0.05),while there was no statistically significant difference between the overweight group and obesity group(P>0.05);the actual measurement values in the 41-<51 years old group,51-<61 years old group and 61-<71 years old group were significantly higher than the predicted values(P<0.05),while there was no statistically significant difference among the other age groups(P>0.05).The linear regression analysis showed that the actual measurement REE value was correlated with gender and age(P<0.05),while the predicted REE value was correlated with gender,age and BMI(P<0.05).Conclusion The REE value calculated by H-B formula has greater difference with the value measured by metabolic cart in the patients with cerebral hemorrhage.It is recommended to use the REE value measured by metabolic cart to guide the individualized nutritional treatment of the patients with cerebral hemorrhage.