体重超标对慢性阻塞性肺疾病患者运动耐量与生存质量的影响

Effect of overweight on exercise tolerance and quality of life in COPD patients

目的探讨慢性阻塞性肺疾病（COPD）患者中体重超标人群与体重正常人群运动耐量及生活质量的差异。方法将入选的113例COPD患者分为三组：正常体重组（43例），超重组（34例），肥胖组（36例）。对所有的受试对象进行静息肺功能检查，踏车实验，圣·乔治呼吸问卷评分。采用SPSS13．0统计软件进行分析。结果体重正常组的FEV。／FVC为（47．28±3．82）％，超重组为（52．50±8．23）％，肥胖组为（53．20±8．30）％，三组间比较差异有统计学意义（F=8．76，P〈0．01）；组间比较正常组与超重组、肥胖组间差异均有统计学意义（P〈0．01），超重组与肥胖组间差异无统计学意义（P〉0．05）；心肺功能运动试验中三组的V02max／kg分别为体重正常组（21．80±3．67）ml·kg^-1·min^-1，超重组（20．19±4．14）ml·kg^-1·min^-1，肥胖组（18．98±3．22）ml·kg^-1·min^-1，差异有统计学意义（F=5．82，P〈0．01），组问比较正常组与超重组比较差异无统计学意义（P〉0．05），超重组与肥胖组比较差异无统计学意义（P〉0．05），正常组与肥胖组比较差异有统计学意义（P〈0．05）；三组间的圣·乔治呼吸问卷评分各项指标与总分差异均无统计学意义（P〉0．05）。结论体重适度增加可提高静息肺通气功能，但明显超出正常水平则会影响患者的运动耐量与运动肺通气。

Objective To explore overweight and obesity on pulmonary function, exercise tolerance, quality of life in COPD. Methods Patients with COPD were divided into three groups： normal body mass index （BM1） （ n = 43 ）, overweight （ n = 34） and obese （ n = 36）. Resting pulmonary function test, cardlopulmonary exercise test （CPET） and St George＇ s respiratory questionnaire （SGRQ） scores were compared during all three classes of BMI. SPSS 13.0 software was used. Results Normal BMI patients （47.28 ± 3.82） % had less FEV1/FVC compared to overweight （52. 50 ± 8.23 ） % and obese （53.20 ± 8.30 ） %, and the difference has statistically significance （F = 8.76, P 〈0.01 ）. There were significant differences in FEVI/FVC between normal BMI patients and obese （P 〈0. 01 ）, normal BMI patients and overweight（P 〈0.01 ）, but not between obese and overweight （P 〉0. 05） by multiple comparison. VO2 max/kg in normal group was （21.80 ±3.67）ml ·kg^-1·min^-1, （20.19 ＋4. 14） ml ·kg^-1·min^-1 in overweight group and （ 18.98 ±3.22） ml ·kg^-1·min^-1 in obese group, and the differences among the three group were significant （ F = 5. 82, P 〈 0. 01 ）. Multiple comparison showed no difference between normal and overweight （ P 〉 0. 05 ）, between overweight and obese group （ P 〉 0. 05 ）, but difference was significant between normal and obese （ P 〈0. 05） ; There was no difference in SGRQ score （ P 〉 0. 05）. Conclusions Weight excess may improve the airflow obstruction of resting pulmonary function test, but exercise tolerance and the airflow obstruction of CPET were worse in obese and overweight.