Finestone Hillel M, Greene-Finestone Linda S, Foley Norine C, Woodbury M Gail
Department of Physical Medicine and Rehabilitation, Elizabeth Bruyère Health Centre, University of Ottawa, Ottawa, Canada.
Stroke. 2003 Feb;34(2):502-7. doi: 10.1161/01.str.0000053031.12332.fb.
Little is known of the acute, subacute, and longer-term energy demands of stroke, information essential to appropriate clinical and nutritional management. The goals of this study were to (1) determine the resting energy expenditure (REE) of stroke patients from stroke onset to 3 months, (2) examine relations between stroke size, type, location, severity, and REE, and (3) evaluate whether estimation of REE from the Harris-Benedict equation (HB) requires the addition of a "stress factor" to capture the possible additional REE imposed by stroke.
The REE of new stroke patients was measured prospectively at hospital admission and on days 7, 11, 14, 21, and 90 by indirect calorimetry. Stroke patients' REEs (Kcal/d) over time and REEs as a percentage of HB were compared with control subjects' single measurements.
Mean REE and %HB of stroke patients ranged from 1521+/-290 to 1663+/-268 Kcal/d and from 107+/-14.9 to 114+/-12.9 %HB, respectively. Mean measurements of control subjects were 1665+/-265 Kcal/d and 112.9+/-11.4 %HB (NS). REE was not associated with stroke characteristics (NS). Changes in REE measured longitudinally were not clinically meaningful (4 to 62 Kcal/d) though statistically significant (P=0.004).
The REEs of stroke patients and controls were both approximately 10% higher than those predicted by HB. No hypermetabolic response pattern of energy expenditure was evident after stroke. REE did not vary with stroke characteristics, although confirmation with larger subgroups is required.
对于卒中的急性、亚急性和长期能量需求了解甚少，而这些信息对于恰当的临床和营养管理至关重要。本研究的目的是：（1）确定卒中患者从发病至3个月的静息能量消耗（REE）；（2）研究卒中大小、类型、部位、严重程度与REE之间的关系；（3）评估根据哈里斯-本尼迪克特方程（HB）估算REE时是否需要增加一个“应激系数”以反映卒中可能带来的额外REE。
对新发卒中患者在入院时以及第7、11、14、21和90天通过间接测热法前瞻性测量其REE。将卒中患者随时间变化的REE（千卡/天）以及REE占HB的百分比与对照组受试者的单次测量结果进行比较。
卒中患者的平均REE和%HB分别为1521±290至1663±268千卡/天以及107±14.9至114±12.9 %HB。对照组受试者的平均测量值分别为1665±265千卡/天和112.9±11.4 %HB（无显著性差异）。REE与卒中特征无关（无显著性差异）。纵向测量的REE变化在临床上无显著意义（4至62千卡/天），尽管在统计学上有显著性差异（P = 0.004）。
卒中患者和对照组的REE均比HB预测值高约10%。卒中后未发现明显的能量消耗高代谢反应模式。尽管需要更大样本亚组进行验证，但REE并未随卒中特征而变化。
