Bott L, Béghin L, Marichez C, Gottrand F
Unité de Gastroentérologie, Hépatologie et Nutrition, Clinique de Pédiatrie, Hôpital Jeanne de Flandre, Lille, France.
Eur J Clin Nutr. 2006 Nov;60(11):1323-9. doi: 10.1038/sj.ejcn.1602463. Epub 2006 Jun 28.
Children with bronchopulmonary dysplasia (BPD) often suffer from growth failure because of disturbances in energy balance with an increase of resting energy expenditure (REE). Evaluation of REE is a useful tool for nutritional management. Indirect calorimetry is an elective method for measuring REE, but it is time consuming and requires rigorous procedure. The objective of this study was to test accuracy of prediction equation to evaluate REE in BPD children.
Fifty-two children aged 4-10 years with BPD (30 boys and 22 girls) and 30 healthy lean children (20 boys and 10 girls) were enrolled. In this study, indirect calorimetry was compared to four prediction equations (Schoffield-W, Schoffield-HW, Harris-Benedict and Food and Agriculture Organization equation) using Bland-Altman pair wise comparison.
The Harris-Benedict equation was the best equation to predict REE in children with BPD, and Schoffield-W was the best in healthy children. For the children with chronic lung disease of prematurity the Harris-Benedict equation showed the lowest mean predicted REE-REE measured by indirect calorimetry difference (difference = 15 kcal/day; limits of agreement -266 and 236 kcal/day; 95% confidence interval for the bias -207 to 177 kcal/day), and graphically, the best agreement. For the group of healthy children, it was the Schofield-W equation (-2.9 kcal/day; limits of agreement -275 and 269 kcal/day; 95% confidence interval for the bias -171 to 165 kcal/day), and graphically, the best agreement.
Differences in prediction equation are minimal compared to calorimetry. Prediction equation could be useful in the management of children with BPD.
支气管肺发育不良（BPD）患儿常因能量平衡紊乱及静息能量消耗（REE）增加而出现生长发育迟缓。评估REE是营养管理的一项有用工具。间接测热法是测量REE的一种可选方法，但耗时且需要严格的操作流程。本研究的目的是检验预测方程评估BPD患儿REE的准确性。
纳入52名4至10岁的BPD患儿（30名男孩和22名女孩）以及30名健康瘦儿童（20名男孩和10名女孩）。本研究采用Bland-Altman成对比较法，将间接测热法与四个预测方程（Schoffield-W、Schoffield-HW、Harris-Benedict和联合国粮食及农业组织方程）进行比较。
Harris-Benedict方程是预测BPD患儿REE的最佳方程，而Schoffield-W方程在健康儿童中表现最佳。对于早产慢性肺病患儿，Harris-Benedict方程显示预测REE与间接测热法测量的REE之间的平均差异最低（差异 = 15千卡/天；一致性界限为-266和236千卡/天；偏差的95%置信区间为-207至177千卡/天），从图形上看，一致性最佳。对于健康儿童组，是Schofield-W方程（-2.9千卡/天；一致性界限为-275和269千卡/天；偏差的95%置信区间为-171至165千卡/天），从图形上看，一致性最佳。
与量热法相比，预测方程的差异最小。预测方程可能有助于BPD患儿的管理。
