Efficacy of nutritional therapy for the physical recovery of stroke patients

【背景与目的】对脑卒中亚急性期代谢需求的了解甚少，这对临床和营养管理至关重要。本研究的目的是：(1)确定卒中后康复患者的静息能量消耗（REE），(2)评估根据Harris-Benedict方程（HB）估算REE是否需要添加应激因子来捕捉卒中可能带来的额外REE。【方法】(1)对脑卒中后康复患者按HB ×应激因子×活动因子方程灌胃1个月，测量体重和AMC。(2)间接量热法测定稀土元素（REE）；(3)最后测定康复前后血清氨基酸分析。【结果】(1)1个月后，给予该公式的康复患者体重下降2.7%，AMC下降1.3%。(2)脑卒中患者的REE比HBs值高约10%（康复后约26%）。(3)氨基酸分析与康复前后无相关性。但部分患者康复后BCAA水平下降。【结论】脑卒中后康复患者的REEs比BB预测值高10%左右。因此，这些患者必须使用公式（HB ×应激因子×活性因子）计算应激因子为+0.2点的增加。

【Background and Purpose】 Little is known of the subacute metabolic demands of stroke, information essential to appropriate clinical and nutritional management. The goals of this study were to (1)determine the resting energy expenditure (REE) of rehabilitation patients after stroke, (2)evaluate whether estimation of REE from the Harris-Benedict equation (HB) requires the addition of a stress factor to capture the possible additional REE imposed by stroke.【Methods】 (1)Rehabilitation patients after stroke were enterally fed on equation( HB × stress factor × activity factor) during 1month, and were measured weight and AMC. (2)The REE was measured by indirect calorimetry, (3)Finally they were measured amino acids analysis in serum before and after rehabilitation.【Results】 (1) Rehabilitation patients fed this equation after 1 month were revealed a 2.7% decrease in Weight and a 1.3% decrease in AMC. (2)The REE of stroke patients was about 10%(about 26% after rehabilitation) higher than the values by the HBs. (3)Amino acids analysis was not associated with pre and post-rehabilitation. But some patients after rehabilitation were decreased in BCAA level.【Conclusions】 The REEs of rehabilitation patients after stroke were about 10% higher than those predicted by BB. Thus these patients must calculate stress factor as a +0.2 point increase using the equation( HB × stress factor × activity factor).