SGA评估慢性阻塞性肺疾病患者的营养状况  

Assess the nutritional status of patients with chronic obstructive pulmonary disease by SGA

作　　者：庄妍[1] 赖雁平[1] 

机构地区：[1]天津医科大学第二医院呼吸科,300211

出　　处：《天津医药》2015年第8期886-888,共3页Tianjin Medical Journal

摘　　要：目的探讨主观全面评估法(SGA)评估慢性阻塞性肺疾病(COPD)患者营养状况的价值。方法选取122例COPD稳定期患者,根据SGA评分结果分为SGA-A(营养良好)组21例、SGA-B(轻-中度营养不良)组57例及SGA-C(重度营养不良)组44例。测定并比较3组的身体测量指数、生化指标、肺功能、COPD评估测试(CAT)及穿梭行走测试(SWT),分析这些指标与SGA评分的相关性。结果 SGA-B组、SGA-C组的体质指数(BMI)、上臂肌围(AMC)和FEV1占预计值的百分比(FEV1%Pred)均低于SGA-A组(P<0.05),SGA-B组与SGA-C组的差异无统计学意义;肱三头肌皮褶厚度(TSF)SGA-C组<SGA-B组<SGA-A组,CAT评分SGA-C组>SGA-B组>SGA-A组(P<0.05);SGA-C组的增量穿梭行走测试(ISWT)距离、耐力穿梭行走测试(ESWT)速度低于SGA-A组(P<0.05);3组的生化指标及第1秒用力呼气量(FEV1)/用力肺活量(FVC)无明显差异(P>0.05)。SGA评分与身体测量指数、FEV1%Pred及运动能力指标呈负相关,与CAT评分呈正相关,与FEV1/FVC及生化指标无相关性。结论SGA与身体测量指数、FEV1%Pred、CAT及SWT具有相关性,可作为COPD患者营养评估的有效工具。Objective To explore the subjective global assessment （SGA） to evaluate the nutritional status of patients with chronic obstructive pulmonary disease（COPD）. Methods Patients with stable COPD （n=122） were included and divided into three groups base on their SGA scores：SGA-A （n=21）, SGA-B （n=57）, SGA-C （n=44）. Nutritional status of all patients was assessed by SGA. Anthropometric measurement, biochemical test, pulmonary function test, COPD assessment test （CAT） and shuttle walking test （SWT） were studied between all three groups to search statistical significance and correlation with SGA. Results Body mass index（BMI）, arm muscle circumference （AMC） and forced expiratory volume in the first second%of predicted （FEV1%Pred） were all lower in SGA-B and SGA-C than those in SGA-A（P〈0.05）,there were no statistical differences of these parameters between SGA-B and SGA-C. Triceps skin fold （TSF） was lower in SGA-C than that in SGA-B than that in SGA-A, while CAT score is the reverse order （P〈0.05）. The walking distance of incremental shuttle walking test （ISWI） and the endurance time of endurance shuttle walking test （ESWI） were lower in SGA-C than that in SGA-A （P〈0.05）. There were no statistical differences of forced expiratory volume in the first second （FEV1）/forced vital capacity（FVC）, biochemical parameters between all three groups. SGA scores correlated positively with CAT and negatively with anthropometric parameters, FEV1%Pred and SWT （P〈0.05）. However no correlations was deduced between SGA scores with FEV1/FVC and biochemical parameters. Conclusion SGA scores correlated with anthropometric parameters, FEV1%Pred, CAT and SWT. SGA is an effective method to assess the nutritional status in patients with stable COPD.

关 键 词：慢性阻塞性肺疾病 主观全面评价法 营养状况 体测指数 生化指标 肺功能 COPD评估测试 穿梭行走测试 

分 类 号：R563[医药卫生—呼吸系统]