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COPD患者肌少症发病情况分析及亮氨酸对肌少症的干预研究

Analysis of the incidence of sarcopenia in patients with COPD and effects of leucine on sarcopenia
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摘要 目的 观察慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)患者中肌少症的发生情况,并评估亮氨酸强化对伴有肌少症的COPD患者肌肉量、肌肉功能、肺功能和营养状况的影响。方法 选择在陕西中医药大学附属医院呼吸内科就诊的306例COPD患者,通过肌肉量和肌肉功能检测,筛选出其中伴有肌少症的患者。将部分伴有肌少症的COPD患者随机分为对照组和研究组,对照组给予常规肠内营养补充,研究组在常规肠内营养之外,补充亮氨酸5 g,每日2次。观察患者干预前,干预2周和4周时的肌肉量、肌肉功能、肺功能和营养状况,并记录两组患者不良反应发生情况。结果 306名COPD患者中,肌少症的发生率为47.4%。与对照组相比,研究组步速、肌少症评分、肌肉量、最大通气量、用力肺活量、第1秒用力呼气容积和最大吸气压均明显升高(P<0.05);研究组白蛋白、前白蛋白在干预4周后明显高于干预前(P<0.05)。两组不良反应发生率无明显差异(P>0.05)。结论亮氨酸强化的肠内营养补充有助于改善伴有肌少症的COPD患者的肌肉衰减情况和肺功能下降。 Objective To observe the occurrence of sarcopenia in patients with chronic obstructive pulmonary disease(COPD),and to evaluate the effect of leucine supplement on muscle mass,muscle function,lung function and nutritional status in COPD patients with sarcopenia.Methods A total of 306 COPD patients treated in Aiffiliated Hospital of Shaanxi University of Chinese Medicine were selected,and the patients with sarcopenia were screened through muscle mass and muscle function tests.The COPD patients with sarcopenia were randomly divided into control group and study group.The control group was given enteral nutrition supplementation,while the study group was supplemented with 5 g of leucine,twice a day,in addition to enteral nutrition.The muscle mass,muscle function,lung function and nutritional status of the patients were observed before the intervention,2 and 4 weeks after the intervention,and the occurrence of adverse reactions in the two groups was also recorded.Results Among 306 COPD patients,the incidence of sarcopenia was 47.4%.Compared with the control group,the pace,sarcopenia score,muscle mass,maximal ventilation,forced vital capacity,forced expiratory volume in 1 second and maximal inspiratory pressure in the study group were significantly increased(P<0.05);the albumin and prealbumin was significantly higher in study group after 4 weeks of intervention(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups,P>0.05.Conclusion Leucine-enhanced enteral nutrition supplementation helps to improve sarcopenia and increase lung function in COPD patients with sarcopenia.
作者 魏丹 WEI Dan(Department of Respiratory Medicine,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)
出处 《延安大学学报(医学科学版)》 2023年第3期87-92,98,共7页 Journal of Yan'an University:Medical Science Edition
关键词 COPD 肌少症 肠内营养 亮氨酸 COPD Sarcopenia Enteral nutrition Leucine
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