靜息能量消耗改變似乎是癌癥患者營養(yǎng)耗盡的原因之一。評定靜息能量消耗可能是對這些患者提供合適營養(yǎng)療法的重要工具。

　　為了評估胃腸道癌癥患者的靜息能量消耗并與健康對照人群對比，巴西米納斯吉拉斯聯(lián)邦大學(xué)的研究者入組了20例患者（食管癌3例、胃癌9例、結(jié)直腸癌8例）和20位健康志愿者，采用間接測熱法檢測兩組的靜息能量消耗，采用“口袋”公式（30kcal/kg）和哈里斯-本尼迪克特公式評定預(yù)期總能量消耗，校正因子分別為1.3（運(yùn)動(dòng)）和1.1（創(chuàng)傷）。統(tǒng)計(jì)學(xué)方法包括曼-惠特尼檢驗(yàn)、配對t檢驗(yàn)、布蘭德·奧爾特曼分析、多變量回歸分析。

　　結(jié)果發(fā)現(xiàn)，患者的靜息能量消耗（1274.5kcal，范圍：1002.9～2174.9）與對照者（1445.5kcal，范圍：1114.5～1762.6）相似（無統(tǒng)計(jì)學(xué)意義），即使校正代謝活躍組織數(shù)量后。口袋公式對預(yù)測患者的總能量消耗有效，與校正之后的間接測熱法結(jié)果相比，存在1.7%的差異（無統(tǒng)計(jì)學(xué)意義）。

　　因此，消化道癌癥患者的靜息能量消耗與對照組相似，目前30kcal/kg的公式適用于估算這些患者的總能量消耗。

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