不同营养状况COPD患者体脂肪量、无脂含量的变化及免疫功能比较

Comparison of fat mass, fat free mass and immune function in different nutritional status patients with chronic obstructive pulmonary disease

目的比较不同营养状况慢性阻塞性肺疾病(COPD)患者体脂肪量(BFM)与无脂组织含量(FFM)的变化以及对免疫功能的影响,为临床治疗提供参考。方法将61例COPD患者分为营养不良组(BMI<18.5 kg/m2)、营养正常组(BMI 18.5～25.0 kg/m2)、肥胖组(BMI>25.0 kg/m2),分别对其进行肱三头肌皮褶厚度(TSF)、BFM、FFM、血清免疫功能测定。结果营养不良组、营养正常组、肥胖组的TSF分别为(0.75±0.06)、(0.96±0.07)、(1.19±0.11) cm,营养不良组TSF低于营养正常组(P<0.05)和肥胖组(P<0.01),营养正常组低于肥胖组(P<0.05);营养不良组、营养正常组、肥胖组的的BFM分别为(14.43±2.04)、(22.85±3.36)、(31.90±5.36) kg,BFM%分别为(33.09±3.81)、(38.41±6.33)、(44.18±10.30)%,营养不良组均显著低于营养正常组、肥胖组(P<0.01),营养正常组低于肥胖组(P<0.01);营养不良、营养正常、肥胖组FFM分别为(28.11±2.56)、(35.07±4.16)、(37.88±7.46) kg,营养不良组低于营养正常组(P<0.05)和肥胖组(P<0.01),营养正常组低于肥胖组(P<0.05);三组患者免疫球蛋白、CD4、CD8均无明显差异。结论COPD患者在注意保持体质量的同时更应该注意保持人体成分的合理比例,尤其应该保持体蛋白质和体质量的合理比例。

Objective To compare fat mass(BFM),fat free mass(FFM)and immune function in different nutritional status patients with chronic obstructive pulmonary disease(COPD).Methods A total of 61 COPD patients were enrolled and divided into three groups:malnutrition group(BMI<18.5 kg/m2),normal nutrition group(BMI 18.5-25.0 kg/m2)and overnutrition group(BMI>25.0 kg/m2).All patients’triceps brachii skin fold thickness(TSF),BFM,FFM and immune function were detected.Results TSF of malnutrition group,normal nutrition group,overnutrition group were(0.75±0.06),(0.09±0.07),(1.19±0.11)cm,respectively;TSF of malnutrition group was lower than those of the other two groups(P<0.05 or P<0.01),and TSF of normal nutrition group was lower than that of overnutrition group(P<0.05).BFM of malnutrition group,normal nutrition group,overnutrition group were(14.43±2.04),(22.85±3.36)and(31.90±5.36)kg,respectively;BFM%of them were(33.09±3.81)%,(38.41±6.33)%,(44.18±10.30)%,respectively;BFM and BFM%of malnutrition group were lower than those of the other two groups(P<0.01),and BFM and BFM%of normal nutrition group were lower than those of overnutrition group(P<0.01).FFM of malnutrition group,normal nutrition group,overnutrition group were(28.11±2.56),(35.07±4.16),(37.88±7.46)kg,respectively;FFM in malnutrition group was lower than that in the other two groups(P<0.05 or P<0.01),and FFM in normal nutrition group was lower than that in overnutrition group(P<0.05).There were no significant differences in immunoglobulin,CD4 and CD8 between the three groups.Conclusion Patients with COPD should pay more attention to maintaining the reasonable proportion of body composition,especially to maintaining the reasonable proportion of body protein and body mass.