食管癌、胃癌、结直肠癌患者的能量消耗
静息能量消耗改变似乎是癌症患者营养耗尽的原因之一。评定静息能量消耗可能是对这些患者提供合适营养疗法的重要工具。
为了评估胃肠道癌症患者的静息能量消耗并与健康对照人群对比，巴西米纳斯吉拉斯联邦大学的研究者入组了20例患者（食管癌3例、胃癌9例、结直肠癌8例）和20位健康志愿者，采用间接测热法检测两组的静息能量消耗，采用“口袋”公式（30kcal/kg）和哈里斯-本尼迪克特公式评定预期总能量消耗，校正因子分别为1.3（运动）和1.1（创伤）。统计学方法包括曼-惠特尼检验、配对t检验、布兰德·奥尔特曼分析、多变量回归分析。
结果发现，患者的静息能量消耗（1274.5kcal，范围：1002.9～2174.9）与对照者（1445.5kcal，范围：1114.5～1762.6）相似（无统计学意义），即使校正代谢活跃组织数量后。口袋公式对预测患者的总能量消耗有效，与校正之后的间接测热法结果相比，存在1.7%的差异（无统计学意义）。
因此，消化道癌症患者的静息能量消耗与对照组相似，目前30kcal/kg的公式适用于估算这些患者的总能量消耗。
JPEN J Parenter Enteral Nutr. 2016;40(4):499-506.
Energy Expenditure in Patients With Esophageal, Gastric, and Colorectal Cancer.
Ceolin Alves AL, Zuconi CP, Correia MI.
Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
BACKGROUND: Changes in resting energy expenditure (REE) appear to be one of the causes of nutritional depletion in cancer. Assessing REE may be an important tool for providing adequate nutritional therapy to these patients. The aims of this study were to evaluate REE of patients with gastrointestinal tract cancer and to compare it to that of healthy controls.
METHODS: A total of 20 patients, with esophageal (n = 3), gastric (n = 9), and colorectal (n = 8) cancers, and 20 healthy subjects were included. Indirect calorimetry (IC) was used to measure REE in both groups. The "pocket" equation (30 kcal/kg) and the Harris-Benedict equation, with correction factors of 1.3 (activity) and 1.1 (injury), were employed for assessment of the estimated total energy expenditure (TEE). Statistics included Mann-Whitney and paired t tests, Bland Altman analysis, and multivariate regression.
RESULTS: The REE of the patients (1,274.5 kcal [1,002.9-2,174.9]) was similar to that of the controls (1,445.5 kcal [1,114.5-1,762.6], not significant), even when corrected for the amount of metabolically active tissue. The pocket equation was effective in predicting the patients' TEE, with a 1.7% (32 kcal) difference being observed in comparison with the IC results corrected with the activity factor (not significant).
CONCLUSIONS: The patients with digestive tract cancers showed a similar REE to that of the controls. The current formula of 30 kcal/kg is suitable for estimating the TEE of these patients.
PMID: 25564427
DOI: 10.1177/0148607114567336
