【摘要】 目的了解恶性肿瘤患儿能量代谢的特点,探索可能影响恶性肿瘤患儿能量代谢的因素。方法芬兰产间接能量测定仪即代谢车全封闭面罩法测定27例恶性肿瘤患儿、15例良性肿瘤患儿及268例正常对照组术前能量消耗值。并进行24小时膳食调查,测量身高、体重,评估营养状况,分析能量消耗值与饮食摄入、营养状况的关系。结果恶性肿瘤组与良性肿瘤对照组、正常对照组预计静息能量消耗值的百分比(PEE)分别为(87.5±22.6)%、(90.2±9.0)%、(89.2±10.6)%,3组比较差异无显著性;良、恶性组间营养状况差异无显著性;恶性肿瘤患儿饮食摄入较良性肿瘤患儿明显不足,分别按有否饮食摄入不足与营养不良将恶性肿瘤患儿分为两组后,两样本t检验比较组间PEE值差异无显著性。结论现有的能量预计公式可能并不适用于中国儿童;恶性肿瘤患儿并非均显示高代谢;饮食摄入减少、营养不良等均无法解释静息能量消耗值的变化;肿瘤本身代谢特点可能是导致恶性肿瘤患儿静息能量消耗值变化的主要原因。更多还原

【Abstract】 Objectives To evaluate the energy metabolism in children with malignant tumors and to explore the characteristics of the energy metabolism in tumor patients. Methods Resting energy expenditure(REE)was measured by indirect calorimetry in 27 children with newly diagnosed malignant tumors and was compared with two groups of control subjects: 15 patients with benign tumors and 268 healthy children. The value was expressed as percent of the predicted REE(PEE, measured REE divided by the predicted value calculated from the Schofield-HTWT formula based on weight, height, age and sex). Body weight and height were also measured in the same day of REE measurement. Energy intake(EI)was determined by 24 hours diet recall. Results The mean PEE of children with malignant tumors was(87.5 ± 22.6)% and not significantly different from healthy subjects with the mean PEE of(90.2 ±9.0)%, while those benign case with the mean PEE of(89.2 ± 10.6)%. Energy intake was significant difference between children with malignant tumors and those with benign tumors, while the nutritional status had no significant difference. Among children with malignant tumors energy expenditure had no significant difference between different energy intake and different nutritional status. Conclusion The currently available energy expenditure formulas may not be suitable for Chinese children. REE is not always high in the malignant cases. Decreased energy expenditure and poor energy intakes can not explain changes of REE values. The tumor metabolism itself may play a key role in energy expenditure of the host.更多还原