Efficacy of nutritional therapy for the physical recovery of stroke patients

[背景与目的]目前对脑卒中亚急性期的代谢需求知之甚少，而这些信息对于适当的临床和营养管理至关重要。本研究的目的是：（1）确定脑卒中后康复患者的静息能量消耗（REE），（2）评估从Harris-Benedict方程（HB）估计REE是否需要增加一个应激因素，以捕获脑卒中可能施加的额外REE。[方法]（1）对脑卒中康复患者按（HB ×应激因子×活动因子）公式进行肠内喂养1个月，测定体重和AMC。（2）用间接量热法测定REE。（3）测定康复前后血清氨基酸含量。[结果]（1）康复患者服用本方1个月后，体重下降2.7%，平均肌张力下降1.3%。（2）脑卒中患者REE比HB值高10%左右（康复后约高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 ×应力因子×活动因子）计算应力因子，即增加+0.2点。

【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).