老年慢性阻塞性肺疾病营养与脂类代谢的变化

The nutrition and lipid metabolism changes of elderly patients with chronic obstructive pulmonary disease

目的 研究老年慢性阻塞性肺疾病 (COPD)急性发作期患者的营养状态和脂类代谢的变化和相互关系。方法 通过人体测量和内脏蛋白测定对 53例 COPD合并呼吸道感染的老年住院患者进行营养评价 ,应用气相色谱法测定血清游离脂肪酸 ,常规方法测定脂类与脂蛋白。结果 营养正常者 (A组 )占 30 2 % ,营养不良者 (B组 )占 69 8% ,两组患者血清甘油三酯 ,总游离脂肪酸均明显下降 (P<0 0 5～ <0 0 1 ) ,其中以亚油酸、亚麻酸等必需脂肪酸降低显著 (P<0 0 1 )。结论 老年 COPD急性发作期患者多伴有甘油三酯和必需脂肪酸缺乏 ,后者可能是加剧 COPD病情恶化的因素之一。

To observe the changes of nutritional status and lipid metabolism in elderly patients with chronic obstructive pulmonaty disease(COPD) complicatied with acute respiratory infection. Methods We assessed nutritional status of 53 cases with COPD through body composition measurements and visceral protein detection. The plasma free fatty acid(FFA) by gas chromatography, the others were tested by routine methods.Results It was found that 14 well nourished patients(30.2%, group A), 37 cases of (69.8%, group B) that the triglyceride(TG) and total FFA were decreased in both groups, and a significan fall content of C18∶2 and C18∶3 essential fatty acids(EFA).Conclusions The absence of EFA is one of the factors that worsened the pathologic course of COPD.