重度COPD患者营养风险与运动耐量的相关性研究  

Correlation between nutritional risk and exercise tolerance in patients with severe chronic obstructive pulmonary disease

作　　者：单锡峥[1] 刘锦铭[2] 罗艳蓉[1] 杨文兰[2] 郭健[2] 

机构地区：[1]同济大学附属杨浦医院呼吸内科,上海200090 [2]同济大学附属肺科医院肺循环科,上海200433

出　　处：《同济大学学报（医学版）》2017年第4期60-65,共6页Journal of Tongji University(Medical Science)

基　　金：中华医学会临床医学慢性呼吸道疾病科研专项基金(08020420120);上海市科学技术委员会科研计划(114119a3000;11411951302)

摘　　要：目的探讨重度慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者营养风险与运动耐量的关系。方法根据营养风险筛查2002标准(NRS-2002)对58例重度COPD患者进行营养风险评估,分为无营养风险组(A组,n=33)及有营养风险组(B组,n=25)。两组分别进行血气分析(arterial blood gas,ABG)、常规肺功能(pulmonary function test,PFT)及心肺运动试验(cardiopulmonary exercise test,CPET)。结果两组间的年龄和身高差异无统计学意义(P>0.05)。B组体质量及BMI低于A组(P<0.01)。血气分析中两组间的paO_2和paCO_2差异无统计学意义(P>0.05)。肺功能检测B组DLCO显著低于A组(P<0.05)。而两组间其他指标(FEV1、FEV1%pred、FVC、FEV1/FVC、RV及RV/TLC)差异无统计学意义(P均>0.05)。心肺运动试验检查B组Peak V·O_2、Peak V·O_2%pred及Peak O_2 pulse显著低于A组(P<0.05,P<0.01)。两组间Peak V·O_2/kg及Peak Load差异无统计学意义(P>0.05)。58例重度COPD患者的NRS评分与Peak V·O_2呈显著负相关(r=-0.353,P<0.01)。58例重度COPD患者的NRS评分与Peak O_2pulse、Peak Load呈负相关(r=-0.322、-0.272,P均<0.05)。结论有营养风险的重度COPD患者的肺换气功能减低更显著,运动耐量下降更明显。重度COPD患者的NRS评分可预测其运动耐量。Objective To investigate the relationship between nutritional risk and exercise tolerance in patients with severe chronic obstructive pulmonary disease （COPD）. Methods The nutritional risk o f 58 severe COPD patients was assessmented according to the nutritional risk screening 2002 （NRS-2002）. There were 33 patients without nutritional risk （NRS 〈3, group A ） and 25 patients with nutritional risk （NRS ≥ 3, group B ）. Arterial blood gas （A BG） analysis, pulmonary function test （PFT） and cardiopulmonary exercise test （CPET） were performed in all patients. Results There were no significant differences in age and height between two groups （P 〉0.05）. The weight [（51.24 ±4.68） k g], BMI （18.34 ± 1.33） in group B were lower than those in group A （P 〈0.01）, There no significant differences in blcxxl gas parameters Pa0 2 and PaC0 2 between two groups （ P 〉 0.05）. Pulmonary function tests showed that the DL of group B was significantly lower than that o f group A （P 〈 0.01） ; while there were no significant differences in other indicators （FEVj, FEV^ pred, FVC, FEY/ FVC, R Y, RV/TLC） between two groups （P 〉0.05）. In cardiopulmonary exercise te s t, Peak V 0 2, Peak V 0 2%pred and Peak O2 pulse in group B were singificantly lower than those in group A （P 〈0.05o r P 〈0.01）. There were no significant differences in Peak VO2/kg and Peak Load between the two groups （P 〉0.05）. NRS score and Peak VO2 of 58 cases of patients with COPD showed a significant negative correlation （r = -0.353, P 〈0.01）. The NRS score of 58 patients with severe COPD was negatively correlated with Peak 0 2 p u lse, Peak Load （r = -0.322^0.272, P 〈0.05）. Conclusion The nutritional risk o f patients with severe COPD can worsen pulmonary ventilation function and decrease exercise tolerance significantly. Nutritional risk assessme

关 键 词：营养风险筛查 慢性阻塞性肺疾病 静态常规肺功能检测 心肺运动试验 

分 类 号：R563[医药卫生—呼吸系统]