Sergi Giuseppe, Coin Alessandra, Mulone Silvana, Castegnaro Eugenio, Giantin Valter, Manzato Enzo, Busetto Luca, Inelmen Emine Meral, Marin Sara, Enzi Giuliano
Department of Medical and Surgical Sciences, Division of Geriatrics, University of Padua, Padua, Italy.
J Gerontol A Biol Sci Med Sci. 2007 Mar;62(3):317-22. doi: 10.1093/gerona/62.3.317.
Our study investigated nutritional status, body composition, and resting energy expenditure (REE) in elderly patients with advanced-stage pressure sores (PS), in addition to researching any hypermetabolic condition and its relationship with PS size.
The study involved 52 institutionalized bedridden elderly women (aged 83.7 +/- 6.3 years), divided into two groups: 23 with advanced-stage (stage 3 and 4) PS and 29 without PS. Albumin, prealbumin, and retinol-binding protein were measured in all patients, and fat-free mass (FFM) and fat mass (FM) were obtained by dual-energy x-ray absorptiometry (DEXA). REE was measured by indirect calorimetry and predicted with the Harris-Benedict formula. PS area and volume were also measured.
The elderly women with and without PS were comparable in age, FFM, and FM. Mean albumin, prealbumin, and retinol-binding protein values were lower in cases with PS. Unadjusted mean REE was significantly higher in patients with PS (1212.3 +/- 236.7 vs 1085.5 +/- 161.3 kcal/d; p <.05), even after adjusting for FFM or expressed per kilogram of body weight (25.8 +/- 6.7 vs 21.1 +/- 4.0 kcal/d/kg; p <.01). Hypermetabolism, i.e., a measured REE > 110% of the predicted REE, was seen in 74% of patients with PS and 38% of controls. The difference between measured and predicted REE (DeltaREE) correlated with PS volume (r = 0.58; p <.01), but not with area.
Advanced-stage PS in elderly women are associated with a hypermetabolic state that is influenced by the volume of the PS.
我们的研究调查了晚期压疮（PS）老年患者的营养状况、身体成分和静息能量消耗（REE），此外还研究了任何高代谢状况及其与压疮大小的关系。
该研究纳入了52名机构化卧床老年女性（年龄83.7±6.3岁），分为两组：23名患有晚期（3期和4期）压疮的患者和29名无压疮的患者。测量了所有患者的白蛋白、前白蛋白和视黄醇结合蛋白，并通过双能X线吸收法（DEXA）获得无脂肪质量（FFM）和脂肪质量（FM）。通过间接量热法测量REE，并使用哈里斯-本尼迪克特公式进行预测。还测量了压疮的面积和体积。
有和无压疮的老年女性在年龄、FFM和FM方面具有可比性。压疮患者的平均白蛋白、前白蛋白和视黄醇结合蛋白值较低。即使在调整FFM或按体重计算后，压疮患者未经调整的平均REE仍显著更高（1212.3±236.7 vs 1085.5±161.3千卡/天；p<.05）（25.8±6.7 vs 21.1±4.0千卡/天/千克；p<.01）。74%的压疮患者和38%的对照组出现高代谢，即测量的REE>预测REE的110%。测量的REE与预测的REE之间的差异（DeltaREE）与压疮体积相关（r = 0.58；p<.01），但与面积无关。
老年女性的晚期压疮与高代谢状态相关，该状态受压疮体积影响。
