肝硬化患者呼出CO_2回收率和能量消耗的研究

Study on Exhale CO_2 Recovery and Resting Energy Expenditure in Patients with Cirrhosis

目的 探讨肝硬化患者呼气中CO2 回收率和能量消耗的变化情况。方法 以13 C -碳酸氢钠 (NaH13 CO3 )为示踪剂 ,采用首剂量结合静脉恒速滴注法及气体同位素比值质谱技术 ,分别对 11例正常人和 14例肝硬化患者呼气中13 CO2 丰度进行测定 ,计算13 CO2 回收率和能量消耗。结果 正常人和肝硬化患者呼气中13 CO2 回收率 ,分别为 ( 80 7± 0 2 6) %和 ( 78 3± 0 84) % ,有显著性差异 ( P <0 0 5 ) ;根据CO2 产生率计算静止状态下能量消耗 ,分别为 ( 3 0 2± 2 4)Kcal·kg-1·d-1和 ( 2 8 4± 3 5 )Kcal·kg-1·d-1,无显著性差异 (P >0 0 5 )。结论 所测定结果可作为制订肝硬化病人营养治疗方案提供理论依据。

Objective To explore the recovery rate of exhale CO 2 and energy expenditure in the patients with cirrhosis.Methods The recovery rate of exhale CO 2 and energy expenditure in fourteen patients with cirrhosis and eleven healthy subjects were measured by using NaH 13 CO 3 as tracer.After overnight fast,all subjects were intravenously given NaH 13 CO 3 at a primed constant rate of infusion for two hours after a saturating dose infusion.Amount of 13 CO 2 in exhale air was measured using stable isotope mass spectrometry analysis,and the recovery rate of exhale CO 2 and energy expenditure were calculated.Results The recovery rate of exhale CO 2 in patients with Cirrhosis was (80 7±0 26)%,and in healthy control subjects was (78 3±0 84)%,which showed a significantly different between the two groups(P<0 05).But the resting energy expenditures,calculated from the CO 2 expiration rate,were not different between the two groups(P>0 05)[(30 2±2 4)Kcal·kg -1 ·d -1 and (28 4±3 5)Kcal·kg -1 ·d -1 ,respectively].Conclusions The results provide theoretical basic to calculate meals for nutritional therapy in the patients with cirrhosis.