慢性阻塞性肺疾病急性加重期病人体质指数与临床结局的关系研究  

Body mass index and clinical outcome in patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：黄蕾[1] 胡绳[2] 田德兴[2] 张继红[3] 梁萍[4] 

机构地区：[1]成都军区成都总医院营养科,四川成都610083 [2]成都军区成都总医院呼吸科,四川成都610083 [3]成都军区成都总医院心血管内科,四川成都610083 [4]成都军区成都总医院耳鼻喉科,四川成都610083

出　　处：《肠外与肠内营养》2012年第3期135-138,共4页Parenteral & Enteral Nutrition

摘　　要：目的:探讨体质指数(BMI)与慢性阻塞性肺疾病急性加重期(AECOPD)病人临床结局的关系。方法:计算177例AECOPD病人的BMI,并进行不同BMI组间AECOPD病人血气指标分析、BMI与机械通气关系分析、BMI与病情转归关系分析和BMI与住院时间(LOS)的相关性分析。结果:低BMI组(BMI<18.5)、正常BMI组(BMI 18.5～23.9)以及高BMI组(BMI>24.0)组间病人PCO2值和PO2/PCO2值均有显著性差异(P=0.032,P=0.024)。多重比较显示,低BMI组病人的PCO2值较正常BMI组高(P=0.020),而PO2/PCO2值和pH值低于正常BMI组(P=0.013,P=0.027)。低BMI组病人实施机械通气的概率比(OR)为正常BMI组的6.015倍。采用年龄分层卡方检验显示,低BMI组中年龄≥70岁的病人死亡OR为正常BMI组的4.06倍,<70岁病人死亡率未显示BMI与死亡率之间的相关性。排除年龄因素,BMI与LOS呈负相关关系(r=-0.165,P=0.038)。结论:低BMI可能导致AECOPD病人机械通气概率增高、住院时间延长、病死率升高等不良临床结局。Objective： To inquire into the relation between the body mass index（BMI）and the clinical outcome in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods： BMI was calculated in 177 AECOPD patients.Analysis of the blood gas analysis,analysis of the relation between BMI and mechanical ventilation,analysis of the relation between BMI and prognosis and analysis of the correlation between BMI and the length of stay（LOS） were carried out in the AECOPD patients in various BMI groups.Results： The PCO2 and PO2/ PCO2 values showed the differences were significant between different BMI groups.Multiple comparisons showed that the PCO2 value was higher in the low BMI group than in the normal BMI group and that the PO2/ PCO2 and pH values were lower in the low BMI group than in the normal BMI group.The odd-ratio of mechanical ventilation in the low BMI group was 6.015 times compared with that in the normal BMI group.The odd-ratio of deathe in the patients≥70 years in the low BMI group was 4.06 times compared with that in the normal BMI group.With the exclusion of the age factor,BMI was negatively correlated with LOS.Conclusion： BMI may increase the ratio of mechanical ventilation,LOS and the mortality rate.Nutritional intervention in chronic obstructive pulmonary disease（COPD） patients with low BMI should be accompanied with other treatment.

关 键 词：慢性阻塞性肺疾病 体质指数 临床结局 

分 类 号：R563.9[医药卫生—呼吸系统]