稳定期慢性阻塞性肺病患者营养评价及短期静脉营养支持

Nutritional Status of Patients with Stable Chronic Obstructive Pulmonary Disease and Effects of Short-term Parenteral Nutritional Support

为探讨稳定期慢性阻塞性肺病 (COPD)患者营养状况及短期静脉营养支持的疗效。测定 6 0例稳定期 COPD患者的营养状况指标、最大口腔吸气压 (MIP)及最大口腔呼气压 (MEP) ,并观察短期静脉营养支持后的疗效。结果发现 6 0例患者中 48.3%体重低于 90 %理想体重。低体重患者 MIP、MEP及外周血淋巴细胞数明显低于正常体重患者(P<0 .0 5 )。低体重患者经静脉营养支持治疗 2周后体重、MIP、MEP及外周血淋巴细胞数明显增加。认为稳定期 COPD患者存在营养不良 ,伴有呼吸肌力减弱。短期静脉营养支持能增强呼吸肌力 ,改善营养状况。

To explore the nutritional status of patients with stable chronic obstructive pulmonary disease (COPD) and the effects of short-term parenteral nutritional support, nutritional status and respiratory muscles strength of 60 patients with stable COPD were observed. Twenty-four of 29 patients whose body weight were lower 90 % of ideal body weight (IBW) were divided into two groups randomly: supplement group (12 cases) receiving parenteral nutritional support and routine treatment and the control group (12 cases) receiving usual treatment. The nutritional status, maximal mouth inspiratory pressure (MIP), maximal mouth respiratory pressure (MEP) and other parameters of the two groups were measured at the beginning and 2 weeks after the study. Results showed that MIP, MEP and the total lymphocyte count (TLC) of the patients with body weight less than 90 % of IBW were obviously lower than that of the patients with normal body weight (P<0.05). In the supplement group, MIP, MEP and TLC improved significantly (P<0.05), while no significant change was found in triceps skinfold trickness (TSF), midarm circumference (MAC), midarm muscle circumference (MAMC) and serum albumin. There was a significant correlation between increment of MIP and MEP expressed as percent predicted and increment of IBW % (r=0.586, 0.637 respectively; P<0.05). In the control group, no significant difference was found in all parameters. It was concluded that in stable COPD patients, the strength of respiratory muscles was decreased as a result of malnutrition. After parenteral short-term nutritional supplement, the strength of respiratory muscles was increased with accompanied improvement of nutritional status.