GOLDⅡ、Ⅲ级的慢性阻塞性肺疾病患者营养状态和临床评价研究  

Study on the nutrition status and clinical evaluation in patients with GOLD Ⅱ and GOLD Ⅲ of chronic obstructive pulmonary disease

作　　者：刘广杰[1] 刘晓芳[1] 卓婕[1] 陈晓[1] 胥杰[1] 王扬[1] 罗秀芳[1] 孙永昌[1] 

机构地区：[1]首都医科大学附属北京同仁医院呼吸内科,100730

出　　处：《中国医师进修杂志（内科版）》2009年第6期25-27,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的总结慢性阻塞性肺疾病（c0PD）GOLDⅡ、Ⅲ级患者的营养状态和呼吸困难等改变，评估GOLD分级判定COPD病情程度的有效性。方法选择稳定期COPD患者30例，病情程度分别处于GOLDII级（GOLDⅡ级组）和GOLDⅢ级（GOLDⅢ级组）各15例。观察患者的体重指数（BMI）、肱三头肌皮褶（鸭F）、血浆白蛋白（Alb）、动脉血氧分压（PaO2）和呼吸困难分级（勃氏分级）。运动负荷试验采用递增负荷的运动方案。结果GOLDⅢ级组和GOLDⅡ级组的BMI分别为（19±5）、（23±3）kg／m^2,TSF分别为（8±3）、（13±5）min，Alb分别为（32±7）、（36±6）g／L，PaO2分别为（72±9）、（78±8）mmHg（1mmHg=0．133kPa），勃氏分级分别为（5．0±2．0）、（3．0±1．0）级，两组比较差异均有统计学意义（P〈0．05或〈0．01）。GOLDⅡ级组12例进行了运动负荷试验，8例测定出无氧阈；GOLDⅢ级组5例进行了运动负荷试验，均未测定出无氧阈。结论COPDGOLDⅢ级患者较GOLDⅡ级病情程度更为严重。在临床工作中，GOLD分级能够较好地反映患者的COPD病情程度和预后评估，具有较高的临床实用价值。Objective To investigate nutrition status and dyspnea in the patients with chronic obstructive pulmonary disease （COPD） between GOLD H and GOLDⅢ, and test the evaluative validity of disease status by GOLD classification of COPD. Methods Thirty patients with clinically stable COPD were recruited, including 15 patients of GOLD Ⅱ of COPD and 15 patients of GOLDⅢof COPD. Body mass index （BMI）, triceps skin-fold thickness （TSF）, serum albumin （Alb）, and partial pressure of oxygen in arterial blood （PaO2） were measured in each patient. Dyspnea was assessed by the Borg Scale （BS）. Exercise stress test was taken by incremental exercise test. Results BMI was significantly lower in the patients of GOLD Ⅲ than that in the patients of GOLD H [ （ 19± 5） kg/m^2 vs （23 ± 3） kg/m^2,P 〈 0.05 ]. TSF was significantly reduced in the patients of GOLD Ⅲ than that in the patients of GOLD Ⅱ [ （8 ± 3 ）mm vs（ 13 ± 5 ） mm,P 〈 0.01 ]. Alb in the patients of GOLD Ⅲ was significantly decreased than that in the patients of GOLD H [ （32 ± 7 ） g/L vs （36± 6） g/L, P 〈 0.05 ]. The difference of PaO2 between the patients of GOLD Ⅲ and the patients of GOLD llwas significant [（72 ± 9） mm Hg （1 mm Hg = 0.133 kPa） vs （78± 8） mm Hg, P〈 0.01 ], and the significant difference of BS was found between the patients of GOLD Ⅲ and the patients of GOLD Ⅱ [（5.0 ± 2.0） grades vs （3.0 ± 1.0） grades, P〈 0.05]. In addition, 12 patients in the patients of GOLD Ⅱ took the exercise stress test and 8 patients were found anaerobic threshold （AT）, 5 patients in the patients of GOLD Ⅲ took the exercise stress test and no AT was found. Conclusions The parameters of BMI, TSF, Alb and PaO2 are significantly reduced in the patients of GOLD Ⅲ than those in the patients of GOLD Ⅱ. In the patients of GOLD Ⅲ, BS is higher than that in the patients of GOLD Ⅱ and AT is dittlcult to obtain, suggesting more severe in degree of impairment. GOLD classification of

关 键 词：肺疾病 慢性阻塞性 营养评价 呼吸困难 

分 类 号：R563.05[医药卫生—呼吸系统] R563.5[医药卫生—内科学]