Mlcak Ronald P, Jeschke Marc G, Barrow Robert E, Herndon David N
Shriners Hospital for Children and Department of Surgery, University Texas Medical Branch, Galveston, TX 77550, USA.
Ann Surg. 2006 Jul;244(1):121-30. doi: 10.1097/01.sla.0000217678.78472.d3.
Recent evidence suggests that female severely burned children have higher endogenous anabolic hormone levels and a shorter ICU stay compared with males. The purpose of this study was to analyze the influence of age and gender on resting energy expenditure (REE) in severely burned children from acute hospitalization through 12 months postburn.
A total of 100 pediatric patients with > 40% total body surface area (TBSA) burn were enrolled in a prospective study and followed by indirect calorimetry measurements. The REE was expressed as actual REE kcal/d, percent of predicted REE, and REE/ body mass index (BMI). Statistical analysis was performed by Student t test and one-way ANOVA for repeated measures. Significance was accepted at P < 0.05.
The measured REE was significantly higher in males versus females at all time points (P < 0.05). The percent of predicted REE was significantly higher in males versus females during the acute hospitalization, at discharge, 6 and 9 months postburn (P < 0.05). The REE/BMI showed a significant difference between males and females at the acute and discharge time period (P < 0.05). In children 3 to 9.9 years of age, the measured REE and the percent of predicted REE were significantly higher in males versus females during the acute study, at discharge and 6 months postburn (P < 0.05). The measured REE at discharge, 9 and 12 months postburn for children >10 years of age was significantly higher in males compared with females (P < 0.05).
Data show that female children exert a decreased hypermetabolic response compared with male children, which may improve burn outcomes in females.
最近的证据表明，与男性相比，严重烧伤的女童体内合成代谢激素水平更高，在重症监护病房（ICU）的住院时间更短。本研究的目的是分析年龄和性别对严重烧伤儿童从急性住院期到烧伤后12个月静息能量消耗（REE）的影响。
共有100例烧伤总面积超过40%的儿科患者纳入一项前瞻性研究，并通过间接测热法进行测量。REE表示为实际REE千卡/天、预测REE的百分比以及REE/体重指数（BMI）。采用学生t检验和重复测量的单因素方差分析进行统计分析。P<0.05被认为具有统计学意义。
在所有时间点，男性的实测REE均显著高于女性（P<0.05）。在急性住院期间、出院时、烧伤后6个月和9个月，男性预测REE的百分比显著高于女性（P<0.05）。在急性住院期和出院时，REE/BMI在男性和女性之间存在显著差异（P<0.05）。在3至9.9岁的儿童中，在急性研究期间、出院时和烧伤后6个月，男性的实测REE和预测REE的百分比显著高于女性（P<0.05）。对于10岁以上的儿童，在出院时、烧伤后9个月和12个月，男性的实测REE显著高于女性（P<0.05）。
数据表明，与男童相比，女童的高代谢反应降低，这可能改善女性的烧伤预后。
