先天性心脏病患儿静息能量消耗的变化。

Changes in resting energy expenditure in children with congenital heart disease.

作者信息

Nydegger A, Walsh A, Penny D J, Henning R, Bines J E

机构信息

Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Parkville, Victoria, Australia.

出版信息

Eur J Clin Nutr. 2009 Mar;63(3):392-7. doi: 10.1038/sj.ejcn.1602956. Epub 2007 Nov 14.

DOI:10.1038/sj.ejcn.1602956

PMID:18000517

Abstract

OBJECTIVES

The aim of this study was to relate changes in energy expenditure and growth in infants with congenital heart disease (CHD), to the timing of corrective cardiac surgery.

METHODS

Prospective cohort study of infants less than 1 year with CHD admitted for cardiac surgery to Royal Children's Hospital, between January to September 2005. Infants were assessed using anthropometry and indirect calorimetry and compared to healthy age-matched controls.

RESULTS

Infants (38) underwent corrective (n=25) or palliative (n=13) cardiac surgery either at < or = 10 days or at >10 days. Infants undergoing corrective surgery after 10 days had deficits in z-scores for weight compared with infants undergoing early surgery (-1.15+/-1.02 vs -0.24+/-0.98; CI 95%: -1.736 to -0.085; P<0.05) and height (-1.47+/-1.16 vs -0.12+/-0.66; CI 95%: -2.262 to -0.428; P<0.01). However, 6 months following surgery, weight and height were similar in both groups. Resting energy expenditure was increased before surgery compared to healthy controls (247+/-36 vs 210+/-22 kJ kg(-1 )day(-1); 95% CI: -57.29 to -16.71; P<0.001) however, normalized 1 week following cardiac surgery. Standard equations did not accurately predict measured REE.

CONCLUSION

Increased REE observed in infants with CHD normalizes within 1 week following corrective cardiac surgery. Deficits in weight and growth were greater in infants undergoing corrective cardiac surgery>10 days of age compared with infants undergoing surgery in the first 10 days of life.

摘要

目的

本研究旨在探讨先天性心脏病（CHD）婴儿的能量消耗变化和生长情况与心脏矫正手术时机之间的关系。

方法

对2005年1月至9月间因心脏手术入住皇家儿童医院的1岁以下CHD婴儿进行前瞻性队列研究。采用人体测量学和间接量热法对婴儿进行评估，并与年龄匹配的健康对照组进行比较。

结果

38例婴儿接受了矫正手术（n = 25）或姑息手术（n = 13），手术时间分别在≤10天或> 10天。与早期手术的婴儿相比，10天后接受矫正手术的婴儿体重z评分较低（-1.15±1.02 vs -0.24±0.98；95%可信区间：-1.736至-0.085；P<0.05），身高z评分也较低（-1.47±1.16 vs -0.12±0.66；95%可信区间：-2.262至-0.428；P<0.01）。然而，术后6个月，两组婴儿的体重和身高相似。与健康对照组相比，术前静息能量消耗增加（247±36 vs 210±22 kJ kg⁻¹ d⁻¹；95%可信区间：-57.29至-16.71；P<0.001），但心脏手术后1周恢复正常。标准方程不能准确预测实测的静息能量消耗。