慢性阻塞性肺病缓解期患者营养状况及对呼吸肌力量的影响  

The effect of nutritional status of patients with stable chronic obstructive pulmonary disease on the strength of respiratory muscles

作　　者：顾宇彤[1,2,3] 蔡映云[1,2,3] 柳启沛[1,2,3] 秦兴国 

机构地区：[1]上海医科大学附属中山医院肺科 [2]上海医科大学营养和食品卫生教研室 [3]上海市纺织局第二职工医院

出　　处：《中华内科杂志》1998年第10期682-685,共4页Chinese Journal of Internal Medicine

基　　金：国家"八五"攻关资助

摘　　要：目的探讨慢性阻塞性肺病（ＣＯＰＤ）缓解期患者的营养状况与呼吸肌力量的关系，以及饮食补充对营养状况和呼吸肌力量的影响。方法测定７６例ＣＯＰＤ缓解期患者的营养指标和最大口腔吸气压（ＭＩＰ）以及最大口腔呼气压（ＭＥＰ）。４１例低体重患者中随机选取２４例分两组，对照组（１２例）维持原先饮食，饮食补充组（１２例）摄入热量平均增加３５％，２周后随访两组患者各营养指标和ＭＩＰ、ＭＥＰ。结果单因素相关分析显示ＭＩＰ占预计值百分比、ＭＥＰ占预计值百分比分别与１秒钟用力呼气容积占预计值百分比、１秒钟用力呼气容积占用力肺活量百分比、每日摄入热量占正常人标准供给量百分比、体重占理想体重身高百分比、体重身高指数和白蛋白呈正相关（Ｐ＜０．０５）。饮食补充组２周后各营养指标、ＭＩＰ和ＭＥＰ均有明显增加。对照组各项指标差异均无显著性。结论ＣＯＰＤ缓解期患者呼吸肌力量减弱与营养不良有关。饮食补充后随着营养状况改善。Objective To study the relationship between nutritional status and respiratory muscle strenth, and the effect of oral supplement on respiratory muscle strenth. Methods Nutritional status and respiratory muscle strenth of 76 patients with stable chronic obstructive pulmonary disease (COPD) were observed. 24 of 41 patients with body weight less than 90% of ideal body weight (IBW), were devided into two groups i.e.a supplement group (12 cases) and a control group (12 cases). The supplement group had their caloric intake increased from 6 004.0 ±1 578.6 J/d to 8 210.3±2 107.9 J/d. The control group (12 cases) took their diet as usual. The nutritional status, maximal mouth inspiratory pressure (MIP), maximal mouth expiratory pressure (MEP) and other parameters of the two groups were measured before and 2 weeks after the study. Results A significant and positive correlation was respectively present between MIP expressed as percent predicted (MIP% pred), MEP expressed as percent predicted (MEP% pred) and forced expiratory volume in 1 second expressed as percent predicted (FEV 1% pred), forced expiratory volume in 1 second to a forced vital capacity (FEV 1/FVC), energy intake to recommended daily intake (E/RDA), IBW expressed as percent pridicted (IBW%), body mass index (BMI) and serum albumin ( P <0.05). No significant relation was found between MIP% pred, MEP% pred and triceps skinfold trickness (TSF), midarm muscle circumference (MAMC). In the supplement group, MIP, MEP and the nutritional parameters improved significant ( P <0.05), while no significant change was found in pulmonary function. There was significant correlation between increment of MIP% pred and increment of IBW%, BMI ( r = 0.591, 0.619 respectively; P <0.05) and between increment of MEP% pred and increment of E/RDA, IBW%, BMI ( r =0.649, 0.698, 0.727 respectively; P <0.05). In the control group, no signficant difference was found in all parameters. Conclusion In stable COPD patients, the strength of respiratory muscles decrea

关 键 词：肺疾病 阻塞性肺疾病 营养障碍 肌收缩 

分 类 号：R563.905[医药卫生—呼吸系统] R459.3[医药卫生—内科学]