慢性阻塞性肺疾病患者营养状态对运动心肺功能的影响

Effect of nutritional state on cardiopulmonary exercise performance in patients with chronic obstructive pulmonary disease

目的 探讨营养状态对慢性阻塞性肺疾病 (COPD)患者运动心肺功能的影响。方法 4 3例COPD患者分为营养不良组 (15例 ) ,营养正常组 (2 8例 )和健康志愿者 (2 0名 )进行负荷连续递增的运动心肺功能试验。运动前行营养评价和常规肺功能检查。结果 (1)COPD营养不良组最大氧耗量 ( VO2 max)、最大运动负荷 (Wmax)、最大氧脉搏 (O2 pulsemax)和无氧阈 (AT)低于营养正常组 ,两组比较差异有显著性 (P <0 0 5 ) ;通气氧耗 ( VO2 /W/ VE)和最大运动时的气急指数 (DImax)与营养正常组比较 ,差异有显著性 (P <0 0 5 )。 (2 )COPD患者理想体重百分比 (IBW % )与 VO2 max占预计值百分比、Wmax占预计值百分比、O2 pulsemax占预计值百分比、AT呈正相关 (r=0 6 96 ,0 4 32 ,0 717,0 82 2 ,P均<0 0 1) ,与DImax、 VO2 /W/ VE 呈负相关 (r=- 0 4 5 0 ,- 0 6 4 0 ,P均 <0 0 1)。结论 营养不良可以导致COPD患者肌肉有氧代谢能力和运动耐力降低。

Objective To explore the effect of nutritional state on cardiopulmonary exercise performance of chronic obstructive pulmonary disease (COPD) patients Methods 43 COPD patients and 20 healthy controls performed incremental cardiopulmonary exercise testing with cycle ergometer Nutritional assessment and routine lung function studies were performed in all subjects before testing Results (1) Compared with the normally nourished COPD group,the malnourished group showed greater reduction in Wmax, O 2max, O 2pulsemax, and AT ( P <0 05), whereas O 2/W/ E and DImax were higher in the malnourished group ( P <0 05) (2) IBW% was positively correlated with O 2max, Wmax, O 2 pulsemax , AT( r =0 696,0 432,0 717,0 822, P <0 01), and negatively correlated with DImax and O 2/W/ E( r =-0 450,-0 640, P <0 01)in COPD patients Conclusion Malnutrition adversely affected muscle aerobic capacity and exercise tolerance in COPD patients