老年慢性阻塞性肺疾病患者静息能量消耗与人体组成  

Resting energy expenditure and body composition in chronic obstructive disease patients of old age

作　　者：范志强[1] 朱惠莉[1] 朱砚萍[1] 梁红[1] 单琳[1] 朱晓颖[1] 

机构地区：[1]上海华东医院呼吸科,200040

出　　处：《国际呼吸杂志》2007年第13期974-977,共4页International Journal of Respiration

摘　　要：目的探讨老年慢性阻塞性肺疾病（COPD）患者与老年正常对照组静息能量消耗（REE）与非脂体质（fat free mass,FFM）、瘦体质（lean mass,LM）的关系,为老年COPD患者营养支持治疗提供依据。方法用间接能量测定法测定43例老年COPD患者（男性25例,女性18例）和40例老年对照者（男性22例,女性18例）的REE,根据Harris-Benedict公式计算REE占预计值的百分比;同时运用双能X线吸收法测定人体组成,即FFM、LM值以及脂肪的比例。结果老年COPD患者FFM占体重比重（FFM%）、LM%均低于对照组,脂体质（FM）%则高于对照组,差异均有统计学意义;COPD组REE%也高于对照组,差异有统计学意义,COPD组基础代谢率（BMR）、REE与FFM和LM的比值（REE/FFM、REE/LM）都高于对照组;Pearson＇s相关性分析显示病例组和对照组REE与体重指数（BMI）、体表面积（BSA）、FFM和LM均呈中重度相关,差异都有统计学意义。结论老年COPD患者REE升高,FFM或LM的比例下降,提示COPD患者常常出现骨骼肌的萎缩。老年COPD患者和对照组REE和FFM和LM也有良好的正相关性。因此,如果样本量足够大,建立REE关于FFM或者LM的回归方程,对于指导临床营养支持治疗可能有一定的实际价值。Objective To discuss the relationship between the resting energy expenditure（REE） and fat-free mass（FFM） or lean mass（LM） in chronic obstructive pulmonary disease（COPD） patients of old age and aged control subjects in order to provide references for the nutritional therapy in aged COPD patients. Methods REE was assessed by indirect calorimetry in 43 COPD patients of old age（25 men, 18 women） and 40 age-matched control subjects（22men, 18 women）. The predicted REE was calculated according the Harris-Benedict equation. The parameters of body composition such as FFM, LM, and fat percentage were determined by dual energy X-ray absorptiometry. Results The percentages of FFM and LM were significantly lower in COPD patients than in control group and the percentage of fat mass in COPD patients were significantly higher. The REE% of aged COPD patients were significantly higher than that of control groups. The REE/FFM, REE/LM, and basal metabolic rate（BMR） were significantly greater in patients group than in control group. The Pearson＇s correlative degrees between REE and BMI, BSA, FFM or LM is moderate or strong in aged COPD patients or control subjects and the correlations is statistically significant. Conclusions The REE in aged COPD patients is higher than normal subjects and the percentage of FFM or LM is decreased. It suggests that muscle wasting is often seen in aged COPD patients. The REE and FFM or LM has strong positive correlation in aged COPD patients or normal subjects so if the number of trial sample is big enough we can establish the linear regression equations of REE and FFM or LM. The equation may has practical value for clinical nutritional therapy.

关 键 词：老年 慢性阻塞性肺疾病 静息能量消耗 人体组成 

分 类 号：R563[医药卫生—呼吸系统]