Fu A, Yoneda T, Yoshikawa M, Takenaka H, Tokuyama T, Tsukaguchi K, Yamamoto C, Narita N, Tomoda K, Cho S
Second Department of Internal Medicine, Nara Medical University, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Jan;36(1):10-7.
We evaluated resting energy expenditure (REE) using canopy mode indirect calorimetry in 21 ambulatory, clinically stable outpatients with pulmonary emphysema (age: 69.3 +/- 8.4, %IBW: 79.3 +/- 12.5, FEV1: 0.98 +/- 0.36) and compared it with that of a 14 age-matched healthy controls (age: 71.1 +/- 6.0, %IBW: 94.5 +/- 13.4). We also compared REE in malnourished patients (%IBW < 90; 73.0 +/- 7.6, N = 14) and normonourished patients (%IBW > or = 90; 92.0 +/- 5.6, N = 7). We examined the relation ship between %REE (REE/REEpred. x 100) and measurements of lung function tests in 21 emphysema patients using single regression analysis. The REE of the patient group was significantly higher than that of the control group (%REE; 115.9 +/- 12.0 vs 86.5 +/- 8.7, p < 0.01). The REE of the malnourished patient subgroup was significantly higher than that of the normonourished patient subgroup (%REE; 121.9 +/- 7.9 vs 109.9 +/- 9.2, p < 0.01). There were no significant differences in FEV1(L), RV/TLC(%), TLC(pred.%) or DLco/VA (pred.%) between the two patient subgroups. The REE of the normonourished subgroup was significantly higher than that of control group (%REE; 109.1 +/- 9.2 vs 86.5 +/- 8.7, p < 0.01). There were significant relations hips among %REE and FEV1, %FVC, FEV1% G, %DLco/VA and RV/TLC (p < .05). These findings suggest that elevated REE may have a significant relation ship with abnormal lung function, and that elevated REE may be a cause of malnutrition in clinically stable patients with pulmonary emphysema.
我们使用面罩模式间接测热法评估了21例非卧床、临床病情稳定的肺气肿门诊患者（年龄：69.3±8.4岁，体重占理想体重百分比：79.3±12.5，第1秒用力呼气容积：0.98±0.36）的静息能量消耗（REE），并将其与14例年龄匹配的健康对照者（年龄：71.1±6.0岁，体重占理想体重百分比：94.5±13.4）的进行比较。我们还比较了营养不良患者（体重占理想体重百分比<90；73.0±7.6，n = 14）和营养正常患者（体重占理想体重百分比≥90；92.0±5.6，n = 7）的REE。我们使用单因素回归分析研究了21例肺气肿患者的REE百分比（REE/预测REE×100）与肺功能测试指标之间的关系。患者组的REE显著高于对照组（REE百分比；115.9±12.0对86.5±8.7，p<0.01）。营养不良患者亚组的REE显著高于营养正常患者亚组（REE百分比；121.9±7.9对109.9±9.2，p<0.01）。两个患者亚组之间在第1秒用力呼气容积（L）、残气量/肺总量（%）、肺总量（预测%）或一氧化碳弥散量/肺泡通气量（预测%）方面无显著差异。营养正常亚组的REE显著高于对照组（REE百分比；109.1±9.2对86.5±8.7，p<0.01）。REE百分比与第1秒用力呼气容积、用力肺活量百分比、第1秒用力呼气容积占预计值百分比、一氧化碳弥散量/肺泡通气量百分比和残气量/肺总量之间存在显著相关性（p<0.05）。这些发现表明，升高的REE可能与异常肺功能有显著关系，并且升高的REE可能是临床病情稳定的肺气肿患者营养不良的一个原因。
