稳定期慢性阻塞性肺疾病患者静息能量和营养指标分析

Study of the resting energy expenditure and nutrition indicators in stable patients with chronic obstructive pulmonary disease

目的:通过比较不同严重程度的慢性阻塞性肺疾病(COPD)患者和正常对照者之间的营养指标和静息能量消耗(REE)的变化,初步探讨它们在病程中的变化规律,为临床的营养干预治疗提供理论依据。方法:选择124例稳定期COPD患者(病例组)和45例健康对照者(对照组),分别检测其肺功能、REE、体重指数(BMI)、血清蛋白,并对其结果进行比较分析。结果:(1)REE在病例组和对照组间差别明显,并随阻塞程度加重而升高;(2)BMI随病情加重逐渐降低,在重度COPD组呈低体重状态;(3)血清蛋白随病情变化趋势不明显,但重度COPD组白蛋白仍明显低于其它各组。结论:COPD患者只有在到达重度阻塞程度时,才会表现出明显的营养不良;在COPD的早期阶段,也具有明显营养不良风险,因此对于轻、中度的COPD患者也应给予积极的预防营养不良措施。

Objective： By comparing the nutrition indicators and the resting energy expenditure （REE） of the different severity patients with chronic obstructive pulmonary （COPD） and the normal control people, approaching the regularity of the variation, for the aim is to provide a theoretical basis for clinical nutrition therapeutic intervention. Methods： 124 cases of stable COPD patients and 45 healthy controls were included, each of them was detected with lung function, REE, BMI, serum protein. And then compare and analyze the results. Result： （1） REE is significantly distinguished between COPD groups and the control group, and increase gradually with the degree of obstruction. （2） BMI decrease gradually with the development of the disease, and low body weight is showed in severe COPD group. （3） Serum protein do not changed with the condition obviously, but the albumin in severe COPD group is sill significantly lower than other groups. Conclusion; （1） The manifestation of malnutrition is obvious to see only in severe obstructive COPD patients. （2） In early stages of COPD, the risk of malnutrition is obviously present too; it shows that positive measures also should be given to prevent malnutrition in mild to moderate COPD patients.