超重及肥胖对老年慢性阻塞性肺疾病病人肺功能的影响

Impact of overweight and obesity on pulmonary function in the elderly patients with chronic obstructive pulmonary disease

目的探讨超重、肥胖对老年慢性阻塞性肺疾病稳定期病人肺功能的影响。方法选取老年慢性阻塞性肺疾病稳定期病人198例,按体质量指数分组,根据年龄进行分层,比较各组间肺功能的差异。结果超重组、肥胖组的呼出75%肺活量时最大呼气流量(V25)、最大呼气中段流量(MMF)、肺总量(TLC)、一氧化碳弥散量(DLCO)和正常体重组比较,差异均有统计学意义(P<0.05)。根据年龄分层,60~75岁组,超重组、肥胖组的V25、MMF、TLC、DLCO和正常体重组比较差异均有统计学意义(P<0.05);>75岁组,超重组、肥胖组的用力肺活量(FVC)、第1秒用力呼气量(FEV1)、呼气峰流量(PEF)、残总比(RV/TLC)和正常体重组比较差异均有统计学意义(P<0.05)。结论超重、肥胖影响老年慢性阻塞性肺疾病病人的限制性通气功能及弥散功能,且在不同年龄组影响不同。

Objective To evaluate the impact of the overweight and obesity on pulmonary function of the elderly patients with stable chronic obstructive pulmonary disease（ COPD）. Methods A population-based sample of 198 subjects with COPD was selected. Subjects were grouped by body mass index（ BMI）,and then categorized according to their ages. The parameters of pulmonary function were detected and compared among groups. Results The differences of forced expiratory flow after 75% of the FCV has been exhaled（ V25）,maximal mid-expiratory flow curve（ MMF）,total lung capacity（ TLC）,diffusion capacity for carbon monoxide（ DLCO） were statistically significant among the groups of the over-weight group（ 24. 0-27. 9）,the obese group（ BMI≥28. 0 kg/m^2） and the normal weight（ 18. 5-23. 9 kg/m^2） group.In the younger group（ aged 60-75 years old）,the levels of V25,MMF,TLC,DLCO were significantly different between the normal weight group,overweight group and obese group,while in the older group（ aged above 75 years old）,the levels of FVC,FEV1,PEF,RV/TLC were significantly different between the normal weight group,overweight group and obese group. Conclusions Obesity affects the restrictive ventilation and diffuse functions of the elderly patients with stable COPD,and the effect is different by age.