高原地区慢性肺原性心脏病缓解期患者营养状况与肺功能的关系  

Relationship between nutritional status and pulmonary function in patients with chronic cor pulmonale during remission period at high altitude area

作　　者：杨生岳[1] 冯恩志[1] 沈君礼[1] 赵丽红[1] 吴雪梅[1] 张冬天[1] 

机构地区：[1]解放军第四医院兰州军区呼吸内科中心,青海省西宁市810014

出　　处：《中国临床康复》2005年第11期22-23,共2页Chinese Journal of Clinical Rehabilitation

基　　金：全军"十五"科研基金资助项目(01MB014)~~

摘　　要：目的:对高原地区慢性肺原性心脏病(简称肺心病)缓解期患者营养状况进行调查,分析营养状况与肺功能的关系,为开展慢性肺心病的饮食干预提供参考依据。方法:2000-01/2003-12在解放军第四医院兰州军区呼吸内科中心住院的高原地区慢性肺心病缓解期患者180例,符合纳入标准的慢性肺心病缓解期患者60例。对60例高原地区慢性肺心病缓解期患者,采用24h膳食回忆法,计算连续5d膳食的摄入。进行身高、体质量、实际体质量占理想体质量百分比(percentageofidealbodyweight,IBW%)、上臂中部周径(mid-upperarmcircumference,MAC、上臂中部肌围)(mid-armmusclecircumference,MAMC)、肱三头肌皮褶厚度(tricepsskinfoldthickness,TSF)测量和血清白蛋白、肺功能测定,分析营养指标与肺功能的关系。结果:高原地区慢性肺心病缓解期营养不良患者热能、蛋白质、脂肪和碳水化合物营养素摄入明显不足。48%的患者IBW%低于90%(体质量降低患者。体质量降低患者MAC,MAMC,TSF,血清白蛋白,第1秒用)力呼气量(forcedexpiratoryvolumein1second,FEV)占预计值百分比1(FEV%、用力肺活量forcedvitalcapacity,FVC、FEV/FVC犤()()22.111±2.0)cm,(18.5±1.9)cm,(10.1±4.5)mm,(36.2±2.6)g/L,(40.4±6.5)%,(0.8±0.3)L,(42.5±7.1)AIM:To investigate the nutritional status of patients with chronic cor pulmonale(CCP) during remission period at high altitude area,and analyze the relation between nutritional status and pulmonary function,so as to provide references for the development of dietary intervention of CCP. METHODS:Totally 180 CCP inpatients during remission period at high altitude area,who were hospitalized in the Respiratory Medical Center of Lanzou Military Area Command, the 4 Hospital of Chinese PLA from January 2000 to December 2003,were selected,and 60 of them,who were in accordance with the inclusion criteria,were involved in this study.A retrospective 24 hour dietary survey was carried out to calculate the dietary intake during 5 successive days.Their body height,body mass,percentage of ideal body mass(IBM% ),mid upper arm circumference(MAC),midarm muscle circumference(MAMC),triceps skinfold thickenss(TSF) were measured,serum albumin(ALB) and pulmonary function were determined.Relation of nutritional status with pulmonary function was analyzed. RESULTS:The dietary intakes of energy,protein, fat and carbohydrate were severely insufficient in the CCP patients during remission period at high altitude area.About 48% of the patients had IBM% lower 90% (patients with reduced body mass),whose MAC,MAMC,TSF,ALB,forced expiratory volume in 1 second(FEV1), expressed as percentage predicted(FEV1% ),forced vital capacity(FVC) and ratio of FEV1 to FVC(FEV1/FVC) [(22.1± 2.0) cm,(18.5± 1.9) cm,(10.1± 4.5) mm,(36.2± 2.6) g/L,(40.4± 6.5)% ,(0.8± 0.3) L,(42.5± 7.1)% ]were significantly lower than those in patients with normal body mass[(29.3± 3.2) cm, (22.8± 2.9) cm, (22.9± 6.4) mm, (41.7± 3.5) g/L, (44.7± 6.3)% , (1.2± 0.4) L,(47.8± 7.2)% ](t=2.81 to 9.56, P< 0.01).Energy,protein, fat,carbohydrate,IBM% ,ALB,MAC,MAMC and TSF had significant positive correlations with FEV1% ,FVC and FEV1/FVC(r=0.278 to 0.545, P< 0.05 to0.01).CONCLUSION:Increment of thermal energy consumption and insufficiency of various nutrion intakes are t

关 键 词：肺疾病 慢性阻塞性 肺心病 营养调查 

分 类 号：R54[医药卫生—心血管疾病]