不同营养状况COPD患者能量消耗、呼吸肌力和免疫功能的比较  

Comparison of energy expenditure, respiratory muscle strength and immune function in different nutritional status patients with chronic obstructive pulmonary disease

作　　者：罗勇[1] 徐卫国[2] 杨玲[2] 陶晔璇[3] 韩锋锋[2] 夏韶民[3] 

机构地区：[1]上海第二医科大学附属新华医院急救中心,上海市200092 [2]上海第二医科大学附属新华医院呼吸内科,上海市200092 [3]上海第二医科大学附属新华医院营养中心,上海市200092

出　　处：《中国临床康复》2003年第15期2186-2188,共3页Chinese Journal of Clinical Rehabilitation

基　　金：上海市高等院校科技发展基金项目(2000B09)~~

摘　　要：目的比较不同营养状况慢性阻塞性肺病患者(COPD)的静息能量消耗(REE)、呼吸肌力量和免疫功能,探讨营养失衡对COPD预后影响的机制。方法将75例COPD患者分为营养不良组A组(体重指数BMI<18.5kg/m2)、营养正常组B组(BMI:18.5～25.0kg/m2),肥胖组C组(BMI>25.0kg/m2)3组,分别对其进行人体测量,最大呼吸肌力、免疫功能与REE测定。结果A,B,C三组REE/Wt分别为(126±25),(96±21),(88±17)kJ/(24h·kg)(P<0.05);A组祛脂群(FFM)为(41±4)kg,显著低于B组和C组,而C组脂群(FM)为(23.2±7.3)kg,占体重的(31±7)%;三组患者免疫球蛋白无明显差异,A组和C组CD4,IL-2较B组显著下降,而CD8显著上升。结论COPD营养状况与其单位体重能量消耗有关,营养不良者FFM低下,而超重者FM比例过高,营养失衡导致人体组成比例严重失调,营养不良和肥胖者细胞免疫功能明显受损。Aim To compare the rest energy expenditure (REE), respiratory muscle st rength and immune status in different nutritional status patients with chronic o bstructive pulmonary disease (COPD) for the further discussion of the prognostic mechanism of obesity and nutritional in patients with COPD.Methods Seventy-fiv e patients with COPD, divided into three groups (A group with malnutrition: BMI< 18.5 kg/m2, B group with normo-nutrition: BMI:18.5-25.0 kg/m2, C group with obesity: BMI >25.0 kg/m2), were detected resting energy expenditure (REE), maxim al respiratory muscle strength and immune function. Results The REE/Wt of A, B, C groups were (126±25),(96±21)and(88±17)kJ/(24 h·kg) respectively (P< 0. 05). The fat free mass(FFM) of A group was (41±4)kg, significantly lower than t hat of B and C groups respectively. The fat mass (FM) of C group was (23.2±7.3) kg, which was (31±7)%of the whole body weight. The humoral immunity of three g roups showed no significant difference, but CD4 and IL-2 of A, C groups were lo wer while CD8 of two groups was higher, compared with B group significantly.Conc lusion The nutritional status of COPD is correlated with energy expenditure to u nit body weight, the body composition of COPD with malnutrition and obesity is o ut of balance severely, and both of them have cellular immunity dysfunction.

关 键 词：COPD 能量消耗 呼吸肌力 免疫功能 慢性阻塞性肺病 营养失衡 

分 类 号：R563.5[医药卫生—呼吸系统]