不同营养状况慢性阻塞性肺疾病患者脂群与祛脂群的比较研究

Comparative study on fat mass and fat-free mass in different nutritional status patients with chronic obstructive pulmonary disease

目的研究和比较不同营养状况慢性阻塞性肺疾病(COPD)患者脂群与祛脂群的变化。方法对59例男性COPD患者和同期来我院体检的49名无呼吸系统慢性疾病的老年男性按体重指数进行营养状况分组。COPD患者营养不良(A1组)19例,营养正常(B1组)26例,超重和肥胖(C1组)14例;对照者营养不良(A2组)14例,营养正常(B2组)18例,超重和肥胖(C2组)17例。采用生物电阻抗法测定研究对象的脂群与祛脂群。结果B1、B2组祛脂群分别为(45.3±3.8)kg、(49.3±4.6)kg,祛脂群%分别为(77.7±5.9)%、(81.2±3.5)%;脂群分别为(13.4±4.1)kg、(11.4±2.2)kg,脂群%分别为(22.9±6.3)%、(18.8±3.5)%;两组差异均有显著性(P值均<0.05)。A1与A2组间,C1与C2组间祛脂群、脂群比较,差异均无显著性(P值均>0.05)。结论与健康对照者相比,营养正常的COPD患者的人体组成明显不同,祛脂群含量明显减少,提示COPD患者往往伴有肌肉和内脏细胞萎缩,可能是导致生活质量下降的原因之一。

Objective To compare fat mass （FM） and fat free mass （FFM） in different nutritional status patients with chronic obstructive pulmonary disease （COPD）. Methods 59 patients with COPD and 49 persons without basic pulmonary diseases who came for health care were divided into different groups according to their body mass index （COPD groups： A1, 19 cases with malnutrition, B1, 26 cases with normo-nutrition, C1, 14 cases with overweight or obesity; control groups： A2, 14 cases with malnutrition, B2, 18 cases with normo-nutrition, C2, 17cases with overweight or obesity）. FM and FFM were studied by bioelectrical analysis. Results FFM of B1, B2 groups were （45.3±3.8） kg, （49.3±4.6） kg respectively （P〈0.01）; the percentage of FFM were （77.7±5.9）%, （81.2±3. 5）% （P〈0.05）; FM were （13.4±4. 1） kg, （11.4±2. 2） kg respectively （P〈0.05）; FM% were （22.9±6.3）%, （18.8±3.5）% （P〈0.01）. There was no significant difference between A1 and A2, or C1 and C2. Conclusion Significant difference is shown in the body composition of COPD with normo-nutrition comparing with the control group. The amount of FFM in patients with COPD decreases obviously, which indicates that one of the mechanisms of decrease of quality of life in patients with COPD is due to atrophy of muscles and visceral cells. （Shanghai Med J, 2005, 28：843-845）