新型冠状病毒肺炎康复期患者膳食蛋白质摄入与肺功能异常的相关性研究

Correlation Between Dietary Protein Intake and Pulmonary Function Abnormality in Convalescent COVID-19 Patients

目的探讨新型冠状病毒肺炎(COVID-19)康复期患者膳食蛋白质摄入量与肺功能异常之间的关系。方法对疫情期间在华中科技大学同济医学院附属协和医院接受治疗的COVID-19患者进行追踪随访调查。采用24 h膳食回顾法进行膳食调查,使用肺功能仪进行肺功能检查。应用Logistic回归模型分析膳食蛋白质摄入量和肺功能异常的关系。结果 43例COVID-19康复期患者,随访时间中位数为345.0(P_(25)~P_(75):336.0~352.0)d。肺阻塞性通气功能障碍(FEV1/FVC预计值<92%)、弥散性功能异常(DLCO预计值<80%)的检出率分别为46.5%和25.6%。膳食蛋白质的摄入量为(60.4±20.7)g,蛋白质供能比为(14.0±4.1)%。通气功能障碍组的患者蛋白质摄入量和供能比均低于通气功能正常组(均P<0.05)。Logistic回归模型中调整研究对象年龄、性别、体质量指数、COVID-19临床分型和总能量摄入量后,与蛋白质摄入量第一分位(T1)组相比较,第三分位(T3)组发生通气功能障碍的风险降低89%(OR=0.11,P<0.05)。此外,蛋白质摄入量每增加10 g/d,通气功能障碍的发生风险降低41%(OR=0.59,P<0.05)。未观察到膳食蛋白质摄入量与肺弥散功能异常之间的关系存在统计学意义(P>0.05)。结论 COVID-19康复期患者较低的膳食蛋白质摄入量与肺通气功能障碍有关;未观察到膳食蛋白质摄入量与肺弥散功能异常相关。

Objective To explore the correlation between dietary protein intake and pulmonary function abnormality in convalescent Corona Virus Disease 2019(COVID-19)patients.Methods The COVID-19 patients treated in Wuhan Union Hospital during the epidemic period were followed up.Twenty-four-hour dietary recall method was used to conduct dietary surveys.A pulmonary function meter was used to test pulmonary function.Logistic regression model was used to analyze the correlation between dietary protein intake and pulmonary function abnormality.Results Forty-three convalescent patients with COVID-19 were followed up for 345.0(P_(25)-P_(75):336.0-352.0)days after discharge.The detection rates of pulmonary ventilation dysfunction(FEV1/FVC<92% of predicted)and diffusion abnormality(DLCO<80% of predicted)were 46.5% and 25.6%,respectively.Dietary protein intake and the ratio of protein energy to total dietary energy were(60.4±20.7)g and(14.0±4.1)%,respectively.Dietary protein intake and the ratio of protein energy to total dietary energy in the pulmonary ventilation dysfunction group were lower than those in the normal group(P<0.05).After adjusting the age, gender, body mass index, COVID-19 clinical classification, and total energy intake in the Logistic regression model, compared with the first tertile(T1)of protein intake group, the risk of ventilation dysfunction was reduced by 89%(OR=0.11,P<0.05)in the third tertile(T3)group.In addition, for per 10 g/day increase in protein intake, the risk of ventilation dysfunction was reduced by 41%(OR=0.59,P<0.05).No statistically significant correlation between dietary protein intake and pulmonary diffusion abnormality was observed(P>0.05).Conclusion This study found that the lower dietary protein intake of convalescent COVID-19 patients was correlated with pulmonary ventilation dysfunction, whereas no correlation between dietary protein intake and diffusion abnormality was observed.