摘要
目的研究慢性丙型肝炎(CHC)患者能量代谢特点,为临床营养干预治疗提供依据。方法选取首都医科大学附属北京佑安医院2004年12月-2014年9月收治的70例CHC患者及30例健康对照(HC)者为研究对象,应用代谢车进行能量代谢指标测定,包括静息能量消耗(REE)、预测REE(p REE)、呼吸商(RQ),以及碳水化合物氧化率(CHO%)、脂肪氧化率(FAT%)和蛋白质氧化率(PRO%)。计数资料采用χ2检验,计量资料两组比较采用独立样本t检验,三组比较采用单因素方差分析。结果 CHC组REE、REE/p REE(%)分别为(1360.46±467.55)kcal/d、(99.07±32.92)%,与HC组比较差异均无统计学意义(P值分别为0.169、0.660)。CHC组RQ、CHO%分别为0.82±0.06、(35.80±19.56)%,低于HC组(P值均为0.000)。CHC组FAT%、PRO%分别为(46.64±22.76)%、(17.56±8.80)%,高于HC组(P值分别为0.011、0.000)。CHC轻度、中度、重度组REE/p REE(%)分为(93.47±26.57)%、(105.42±37.88)%、(116.09±46.24)%,3组比较差异无统计学意义(P=0.092);RQ分别为0.84±0.06、0.81±0.06、0.78±0.05,3组比较差异有统计学意义(P=0.001)。不同基因分型肝损伤程度差异无统计学意义(P=0.312),1b基因型组RQ为0.81±0.06、低于非1b基因型组0.85±0.06,差异有统计学意义(P=0.010)。结论 CHC患者REE总体呈正常代谢状态,随着肝损伤程度加重,REE增加;CHC患者存在营养物质代谢障碍,以FAT%及PRO%上升,CHO%降低为主,与肝功能损伤程度及基因分型有一定相关性。
Objective To characterize the energy metabolism in patients with chronic hepatitis C （CHC）and to provide a basis for clinical nutrition intervention.Methods This study included 70 cases of chronic hepatitis C （CHC）admitted to Beijing YouAn Hospital affiliated to Capital Medical University from December 2004 to September 2014,as well as 30 healthy controls （HCs）.Energy metabolism indices were measured with the critical care management system,including resting energy expenditure （REE）,predicted resting energy expenditure （pREE）,respiratory quotient （RQ）and carbohydrate oxidation rate （CHO%）,fat oxidation rate （FAT%）,and protein oxidation rate （PRO%）.Comparison of categorical data was made by chi -square test;for continuous data,comparison between two groups was made by independent -samples t test,while comparison between three groups by one -way analysis of variance.Results REE and REE /pREE （%）in the patients with CHC were 1360.46 ±467.55 kcal/d and 99.07% ±32.92%,respectively,without significant differences com-pared with those in HCs （P =0.169;P =0.660）.RQ of 0.82 ±0.06 and CHO% of 35.80% ±19.56% in CHC patients were lower than those in HCs.（P =0.000;P =0.000）.FAT% and PRO% in the participants with CHC were 46.64% ±22.76% and 17.56% ± 8.80%,respectively,significantly higher than those in HCs （P =0.011;P =0.000）.REE /pREE （%）in the CHC patients with mild, moderate,and severe liver injury was 93.47% ±26.57%,105.42% ±37.88%,and 116.09% ±46.24%,respectively;there were no significant differences across the three groups （P =0.092）.For the three groups,RQ was 0.84 ±0.06,0.81 ±0.06,and 0.78 ±0.05, respectively,and differed significantly （P =0.001）.There were no significant differences in the severity of liver injury between patients＆nbsp;with different genotypes （P =0.312）.RQ was 0.81 ±0.06 for CHC patients with 1b genotype versus 0.85 ±0.06 for non -1b genotypes （P =0.010）.Conclusion Generally,CHC patients show a normal metabolic st
出处
《临床肝胆病杂志》
CAS
2015年第5期716-720,共5页
Journal of Clinical Hepatology
基金
北京市科技计划重大项目(H020920020890)
国家卫计委2014重点建设专科项目(WJWYA-2014-001)
关键词
肝炎
丙型
慢性
能量代谢
hepatitis C,chronic
energy metabolism
