短期静脉营养对COPD患者能量代谢和运动耐量的影响

Effects of short term intravenous nutritional supply on energy metabolism and exercise intolerance in chronic obstructive pulmonary disease

目的：探讨短期静脉营养对慢性阻塞性肺病（ＣＯＰＤ）并发营养不良（ＭＮＣＯＰＤ）能量代谢和运动耐量的影响。方法：ＣＯＰＤ缓解期病人３０例，按治疗方案分为两组：Ａ组（营养膳食＋静脉营养组）１５例，Ｂ组（营养膳食组）１５例。静脉营养采用华瑞公司生产的英脱利匹特（Ｉｎ－ｔｒａｌｉｐｉｄ）和凡命（Ｖａｍｉｎ）等。治疗前及治疗１周后作营养评价、静息能量消耗（ＲＥＥ）、运动试验和呼吸肌张力测定。结果：两组均存在蛋白质－能量型营养不良，治疗后Ａ组营养指标有显著改善，静息能量消耗、三大营养素消耗供能率更趋合理；功率氧耗（ΔＶ·Ｏ２／ΔＷ）、运动通气氧耗（Ｖ·Ｏ２／Ｗ／Ｖ·Ｅ）降低；呼吸肌张力（ＰＩｍａｘ，ＰＥｍａｘ）较Ｂ组明显改善。结论：短期静脉营养能改善营养指标和三大营养素消耗供能率；

Objectives:The study was done to investigate the effects of short term intravenous nutritional supply on energy metabolism and exercise intolerance in chronic obstructive pulmonary disease associated with malnutrition(MN COPD). Methods:According to treatment methods,30 stable MN COPD patients were divided into two groups:Group A had 15 cases treated with nutritional food and intravenous nutritional supply and Group B had 15 cases treated only with nutritional food.Intravenous nutritional supply was accomplished with Intralipid and Vamin produced by Sino Swed Pharmaceutical Corp.Ltd.Rest energy expenditure(REE),exercise test and respiratory muscle strength were measured before and 1 week after the treatment. Results:Both of the groups had malnutrition of protein energy type.In Group A,nutritional parameters were significantly improved,and REE and consumption of 3 kind of nutritional materials became more optimal after the treatment.Oxygen consumption per workload(Δ V· O 2/ΔW) and exercise ventilation oxygen consumption( V· O 2/W/V·E) were more decreased in Group A than those in Group B,with tensions of the respiratory muscle(PImax and PEmax) being more improved. Conclusions:Short term intravenous nutritional treatment can improve nutritional parameters,consumption of three kind of nutritional materials for energy and tension of the respiratory muscle.