Body composition, physiological function and psychological changes in patients with predicted severe acute pancreatitis
Body composition, physiological function and psychological changes in patients with predicted severe acute pancreatitis
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DOI：
10.1159/000055793
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发表时间：
2001-01-01
期刊：
影响因子：
3.6
通讯作者：
Johnson, CD
中科院分区：
文献类型：
--
作者：
Gupta, R;Rajani, R;Johnson, CD
背景。严重败血症和重大钝性创伤对身体成分、生理功能和心理状态都有不良影响。重症急性胰腺炎对这些变量组的影响尚未有报道。方法：研究预测重症急性胰腺炎（入院APACHE II评分≥6分）对入院时体脂和中臂肌围（通过双能X线骨密度测量和人体测量评估）、呼吸功能（通过肺活量测定和生命描记测量）、随意肌功能（通过手测力测量）和心理状态（通过医院焦虑抑郁评分和视觉模拟疲劳量表测量）的影响，以及三及其后七日。结果：本研究中 15 名患者（7 名男性）的 APACHE II 评分中位数为 10（6-13）。患者呼吸功能显着改善（FEV，1.3、1.6、2.3 升/秒，p < 0.01；FVC 1.5、2.0、2.9 升，p < 0.01；PEFR 304、372、409 升/分钟，p = 0.01，但随意肌功能没有变化（210、205、213 N, p = 0.41) 在 7 天的研究期间，心理状态在疲劳 (2.4, 4.2, 7.0, p < 0.01) 和抑郁 (6, 9, 4, p = 0.12) 方面有所改善，但在焦虑方面没有改善 (8, 6, 7, p = 0.07)。 p = 0.13）和中上臂肌肉周长（262、248、251 mm，p = 0.10）没有变化，这意味着在 7 天的研究期间实现了能量和氮平衡。结论：与严重败血症中观察到的情况相似，这些变量的改善在 7 天的有效治疗中是明显的。版权所有 (C) 2001 S. Karger AG，巴塞尔和 IAP。
Background. Serious sepsis and major blunt trauma have adverse effects on body composition, physiological function and psychological state. The effect of severe acute pancreatitis on these groups of variables has not yet been reported. Methods: We have studied the effect of predicted severe acute pancreatitis (admission APACHE II score greater than or equal to6) on body fat and mid arm muscle circumference (assessed by dual-energy X-ray absorptiometry and anthropometry), respiratory function (measured by spirometry and vitalography), voluntary muscle function (measured by hand dynamometry) and psychological state (measured by use of the hospital anxiety and depression score and visual analogue scale for fatigue) on admission, and three and seven days thereafter. Results: The median APACHE II score of the 15 patients (7 men) in this study was 10 (6-13). The patients showed significant improvement in respiratory function (FEV, 1.3, 1.6, 2.3 litres/s, p < 0.01; FVC 1.5, 2.0, 2.9 litres, p < 0.01; PEFR 304, 372, 409 litres/min, p = 0.01 but no change in voluntary muscle function (210, 205, 213 N, p = 0.41) over the 7-day study period. Psychological state improved in terms of fatigue (2.4, 4.2, 7.0, p < 0.01) and depression (6, 9, 4, p = 0.12) but not in anxiety (8, 6, 7, p = 0.07). Body fat measured by DEXA (17.3 kg on admission, 16.7 kg on day 7, p = 0.13) and the mid upper arm muscle circumference (262, 248, 251 mm, p = 0.10) did not change implying that energy and nitrogen balance over the 7-day study period was achieved. Conclusion: Predicted severe acute pancreatitis has an adverse effect on respiratory function and psychological state similar to that observed in serious sepsis. Improvement in these variables is apparent over 7 days of effective treatment. Further research is indicated to examine the effect of nutritional support on these variables. Copyright (C) 2001 S. Karger AG, Basel and IAP.