Pamatmaiņas noteikšana krūts vēža pacientēm ķīmijterapijas laikā
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Date
2024
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Pētījuma aktualitāte: Onkoloģijas pacientu vielmaiņu ietekmē gan pati slimība, gan psihoemocionālais stāvoklis, aktivitāšu līmeņa maiņa - bieži samazināšanās, ķīmijterapijas laikā lietotie medikamenti un citi faktori. Tādējādi ir grūti prognozēt nepieciešamo enerģijas daudzumu ar matemātiskajām aprēķina metodēm (piem., Harisa-Benedikta formulu). Netiešās kalorimetrijas pielietošana ir ieteicama, lai veidotu uztura terapiju kritiski slimiem pacientiem, novēršot nepietiekamas un pārmērīgas barošanas nelabvēlīgo ietekmi. Netiešā kalorimetrija ir zelta standarts enerģijas patēriņa aprēķināšanai. Krūts vēzis ir ļaundabīgs audzējs, kas visbiežāk rodas no krūts dziedzeru epitēlija. Tā ir visbiežāk diagnosticētā vēža forma visā pasaulē un galvenais sieviešu mirstības cēlonis no visiem vēža veidiem.
Pētījuma mērķis: Ar netiešās kalometrijas metodi novērtēt pacienšu vielmaiņu un salīdzināt ar rezultātiem, kuri iegūti ar Harisa-Benedikta formulu un salīdzināt ar Eiropas Klīniskā uztura biedrības (ESPEN) vadlīnijām un ar uzturu uzņemto enerģijas daudzumu.
Pētījuma metodes: Šķērsgriezuma pētījums. Pētījumā tika iekļautas 14 pacientes, kuras ieradās uz ķīmijterapiju Rīgas Austrumu klīniskās universitātes slimnīcā (RAKUS) Ķīmijterapijas dienas stacionārā Latvijas onkoloģijas centrā ar pamatdiagnozi C50 – pēc SSK-10 klasifikācijas “Krūts ļaundabīgs audzējs”. Pamata vielmaiņas (PV) mērīšanai tika izmantots netiešais kalorimetrs (COSMED Q_NRG). Matemātiskās prognozešanas metodei tika izmantots Harisa-Benedikta vienādojums. Tika aprēķināts ieteicamais kaloriju daudzums pēc ESPEN vadlīnijām. 24 h uztura datu atcerēšanās anketas dati tika analizēti interneta vietnē fineli.fi.
Rezultāti un secinājumi: Tika novērota statistiski ticama, vidēji cieša pozitīva korelācija gan starp izmērīto un izrēķināto PV un starp kopējo enerģijas patēriņu. Pacientēm, kuras uzsāka ķīmijterapiju, PV bija līdzīgs izrēķinātajam. Pacientēm, kuras ķīmijterapiju saņēma ilgākā laika periodā, izmērītā PV bija zemāka kā ar Harisa-Benedikta vienādojumu rēķinātā. Starp aprēķināto un rekomendēto kopējo enerģijas patēriņu nav statistiski nozīmīgas starpības. Statistiski nozīmīga starpība tika novērota starp izmērīto, aprēķināto un uzņemto enerģiju. Pacientes uzņēma mazāk kaloriju kā rekomendēts.
Topicality of research: The metabolism of oncological patients is affected by the disease itself and the psycho-emotional state, change/decrease in activity level, medications used during chemotherapy and other factors. It is difficult to predict the required amount of energy with mathematical equalitation methods (e.g. Harris-Benedict equalitation). Indirect calorimetry is recommended to formulate nutritional therapy for critically ill patients, preventing the effects over- and underfeeding. Indirect calorimetry is generally accepted as the gold standard for measuring the rest energy expenditure (REE). Breast cancer is cancer that forms in the cells of the breasts. Breast cancer is the leading cause of cancer death in women all over the world. Aim of research: Measuring the resting energy expenditure (REE) of patients using the indirect calometry method and compare with the results with the one calculated with Harris-Benedict equalition and compare with the ESPEN guidelines and the amount of energy intake. Methods: Cross-sectional study design. Participants - 14 patients with diagonosis C50 - Malignant neoplasm of breast (by SSK-10). Patients were receiving chemotherapy on day stationary in Riga East University hospital clinical centre - Oncology Centre of Latvia. Patients resting energy expenditure (REE) was measured using a indirect calorimeter (COSMED Q-NRG). Harris-Benedict equalitation was used to calculate REE. Recommended caloric intake was calculated according to ESPEN guidelines. Data from the 24-hour Dietary were analyzed using finelli.fi food composition database. Results and conclusions: A statistically reliable, moderately close positive correlation was observed both between measured and calculated REE and between actual energy consumption. In patients who started chemotherapy, the REE was similar to the calculated one. In patients who received chemotherapy for a longer period of time, the measured REE was lower than that calculated by the Harris-Benedict equation. There is no statistically significant difference between the calculated and recommended total energy expenditure. A statistically significant difference was observed between measured, calculated and data from the 24-hour Dietary. The patients consumed fewer calories than recommended.
Topicality of research: The metabolism of oncological patients is affected by the disease itself and the psycho-emotional state, change/decrease in activity level, medications used during chemotherapy and other factors. It is difficult to predict the required amount of energy with mathematical equalitation methods (e.g. Harris-Benedict equalitation). Indirect calorimetry is recommended to formulate nutritional therapy for critically ill patients, preventing the effects over- and underfeeding. Indirect calorimetry is generally accepted as the gold standard for measuring the rest energy expenditure (REE). Breast cancer is cancer that forms in the cells of the breasts. Breast cancer is the leading cause of cancer death in women all over the world. Aim of research: Measuring the resting energy expenditure (REE) of patients using the indirect calometry method and compare with the results with the one calculated with Harris-Benedict equalition and compare with the ESPEN guidelines and the amount of energy intake. Methods: Cross-sectional study design. Participants - 14 patients with diagonosis C50 - Malignant neoplasm of breast (by SSK-10). Patients were receiving chemotherapy on day stationary in Riga East University hospital clinical centre - Oncology Centre of Latvia. Patients resting energy expenditure (REE) was measured using a indirect calorimeter (COSMED Q-NRG). Harris-Benedict equalitation was used to calculate REE. Recommended caloric intake was calculated according to ESPEN guidelines. Data from the 24-hour Dietary were analyzed using finelli.fi food composition database. Results and conclusions: A statistically reliable, moderately close positive correlation was observed both between measured and calculated REE and between actual energy consumption. In patients who started chemotherapy, the REE was similar to the calculated one. In patients who received chemotherapy for a longer period of time, the measured REE was lower than that calculated by the Harris-Benedict equation. There is no statistically significant difference between the calculated and recommended total energy expenditure. A statistically significant difference was observed between measured, calculated and data from the 24-hour Dietary. The patients consumed fewer calories than recommended.
Description
Uzturs
Nutrition
Veselības aprūpe
Health Care
Nutrition
Veselības aprūpe
Health Care
Keywords
netiešā kalorimetrija, enerģijas patēriņš miera stāvoklī, pamata vielmaiņa, krūts vēzis, ķīmijterapija., indirect calorimetry, rest energy expenditure, breast cancer, chemotherapy.