损伤代谢反应中的年龄相关差异。

Age-related differences in the metabolic response to injury.

作者信息

Frankenfield D, Cooney R N, Smith J S, Rowe W A

机构信息

Department of Clinical Nutrition, Milton S. Hershey Medical Center, Hershey, PA 17033, USA.

出版信息

J Trauma. 2000 Jan;48(1):49-56; discussion 56-7. doi: 10.1097/00005373-200001000-00009.

DOI:10.1097/00005373-200001000-00009

PMID:10647565

Abstract

OBJECTIVE

To investigate the effect of age on the metabolic response to injury.

METHODS

Fifty-two trauma patients meeting entrance criteria were prospectively enrolled. Patients were grouped by age: elderly, >60 years; and young, < or =60 years. After 4 days of nutrition support, physiologic and laboratory data were collected. Energy and nitrogen metabolism, and body composition were evaluated.

RESULTS

Elderly patients demonstrated a reduced incidence of fever (48% vs. 77%,p = 0.027). Independent of body composition, temperature, and injury severity, oxygen consumption was 8% lower in the elderly (p = 0.0032). However, nitrogen loss and myofibrillar catabolic rate was not altered by age. Elderly subjects were more often hyperglycemic (38% vs. 0%, p < 0.0001) and azotemic (62% vs. 22%, p = 0.004), despite similar carbohydrate and protein intake.

CONCLUSION

Fever is less common and oxygen consumption lower in elderly trauma patients. Postinjury myofibrillar protein catabolism and nitrogen loss are not influenced by aging. Metabolic complications of nutrition support (hyperglycemia, azotemia) are more common in elderly trauma patients.

摘要

目的

探讨年龄对损伤代谢反应的影响。

方法

前瞻性纳入52例符合入选标准的创伤患者。患者按年龄分组：老年组，年龄>60岁；年轻组，年龄≤60岁。营养支持4天后，收集生理和实验室数据。评估能量和氮代谢以及身体组成。

结果

老年患者发热发生率较低（48% 对 77%，p = 0.027）。不考虑身体组成、体温和损伤严重程度，老年患者的耗氧量低8%（p = 0.0032）。然而，年龄并未改变氮丢失和肌原纤维分解代谢率。尽管碳水化合物和蛋白质摄入量相似，但老年受试者高血糖（38% 对 0%，p < 0.0001）和氮质血症（62% 对 22%，p = 0.004）更为常见。