Kane R E, Hobbs P
Department of Pediatrics, St. Louis University School of Medicine, Missouri.
J Pediatr Gastroenterol Nutr. 1991 Feb;12(2):217-23. doi: 10.1097/00005176-199102000-00014.
The basal energy expenditure (BEE) in a group of adolescent and young adult patients with cystic fibrosis (CF) with mild lung disease was 97 +/- 6% of that predicted by the Harris-Benedict equation (which estimates BEE by age, sex, height, and weight). The BEE of a group with more severe lung disease was 117 +/- 5% of that predicted by the Harris-Benedict equation, due primarily to a 14% greater oxygen consumption (VO2) and 24% greater CO2 production (VCO2) compared with milder lung disease (p less than 0.05). The measured BEE in the patients with mild lung disease correlated well with the predicted BEE, but variably underestimated that of patients with more advanced lung disease. The influence of low carbohydrate (Pulmocare) and higher carbohydrate (Instant Breakfast) nutritional supplements on the energy and pulmonary metabolism was compared in 10 malnourished CF patients with moderate to severe lung disease. Their BEE before ingesting the supplements was 120% of that predicted by the Harris-Benedict equation. Their VCO2 increased 9-19% for the 3 h after ingesting 500 kcal/M2 of Pulmocare, and 25-30% after ingesting Instant Breakfast (p less than 0.05). The respiratory quotient (RQ) was significantly greater for Instant Breakfast than Pulmocare. The minute ventilation (VE) rose 10-13% for the 3 h after ingesting Pulmocare, versus 27-31% after ingesting Instant Breakfast, but the difference was not significant. The metabolic expenditure rose 13-16% for the 3 h after ingesting both formulas. We concluded that CF patients have increasing difficulty maintaining their nutrition as their pulmonary disease progresses, in part because of a 17-20% increase in their BEE.(ABSTRACT TRUNCATED AT 250 WORDS)
一组患有轻度肺部疾病的青少年和青年成年囊性纤维化（CF）患者的基础能量消耗（BEE）为哈里斯-本尼迪克特方程（根据年龄、性别、身高和体重估算BEE）预测值的97±6%。一组患有更严重肺部疾病患者的BEE为哈里斯-本尼迪克特方程预测值的117±5%，这主要是因为与轻度肺部疾病相比，其耗氧量（VO2）高14%，二氧化碳生成量（VCO2）高24%（p<0.05）。轻度肺部疾病患者测得的BEE与预测的BEE相关性良好，但对肺部疾病更严重患者的BEE估算存在差异。在10名患有中度至重度肺部疾病的营养不良CF患者中，比较了低碳水化合物（Pulmocare）和高碳水化合物（速溶早餐）营养补充剂对能量和肺部代谢的影响。他们在摄入补充剂前的BEE为哈里斯-本尼迪克特方程预测值的120%。摄入每平方米500千卡Pulmocare后3小时，他们的VCO2增加了9 - 19%，摄入速溶早餐后增加了25 - 30%（p<0.05）。速溶早餐的呼吸商（RQ）显著高于Pulmocare。摄入Pulmocare后3小时，分钟通气量（VE）上升了10 - 13%，摄入速溶早餐后上升了27 - 31%，但差异不显著。摄入两种配方后3小时，代谢消耗均上升了13 - 16%。我们得出结论，CF患者随着肺部疾病进展，维持营养的难度越来越大，部分原因是其BEE增加了17 - 20%。（摘要截选至250字）
