健康新生儿静息能量消耗的研究

Resting energy expenditure in healthy newborn infants

目的 检测我国健康新生儿静息能量消耗值 (REE) ,评估不同因素对其的影响。方法通过开放式间接能量测定仪 (DeltatracTMⅡ ,芬兰 )对 15 4例出生体重 2 5 0 0～ 3 999g的健康新生儿 (男75名 ,女 79名 )进行REE检测 ,与Schofield预计公式所得的预计值进行比较 ,同时比较性别和分娩方式对新生儿REE的影响。结果 健康新生儿的REE平均实测值为 ( 2 0 1 8± 2 5 4)kJ/ (kg·d) ,预计值为 :( 2 2 6 1± 4 8)kJ/ (kg·d) ,两者之间差异有显著性 ,预计值比实测值高出 12 0 4%。性别及分娩方式对新生儿REE无影响。结论 现有的预计公式并不适用于临床估算新生儿能量消耗 ,对新生儿进行间接能量测定是了解其能量消耗的较好方法。本研究推荐中国健康新生儿 (出生体重 2 5 0 0～ 3 999g)静息能量消耗值为 ( 2 0 1 8± 2 5 4)kJ/ (kg·d) ,95 %可信区间为 ( 15 2 0～ 2 5 1 6)kJ/ (kg·d)。

Objective To establish the value of the resting energy expenditure (REE) in healthy newborns and evaluate relative factors of REE. Methods One hundred and fifty-four healthy newborns (75 boys, 79 girls; birth-weight 2 500-3 999 g) were enrolled in this study. The Apgar score at the 5 th minute was equal to or more than 8; the postnatal age was equal to or more than 5 days. The newborns had no apparant defect. The mothers had no history of metabolic and endocrine diseases. REE was measured by Deltatrac TMⅡin child canopy mode for 30-45 minutes during asleep or quiet awake status. Results The average REE was (201.8±25.4)kJ/ (kg·d), which was significantly lower than the predicted REE by Schofield formula[(226.1±4.8)kJ/(kg·d), P=0.000], the predicted REE was 12.04% higher than the measured REE. There were no differences in sex and ways of delivery. The newborns whose birth-weight was between 2 500-2 999 g were measured in two modes: baby and child mode, and the REE values were significantly higher (122.6±25.0)kJ/(kg·d) and (208.8±26.4)kJ/(kg·d),respectively (P=0.000). Conclusions The prediction formula might be improper for calculating the REE in newborn infants. The indirect calorimetry was the better way to know the actual REE of newborns. The authors recommended that in child mode the measurement of REE in newborns would be the indirect calorimetry, and the REE in healthy newborns was (201.8±25.4)kJ/(kg·d).