精氨酸对慢性阻塞性肺疾病呼吸衰竭合并营养不良的作用

Effect of arginine in nutritional support for malnourished patients with chronic obstructive pulmonary disease complicated with respiratory failure

目的 评价精氨酸对慢性阻塞性肺疾病 (COPD)呼吸衰竭营养支持的作用。方法 对 30例COPD患者进行营养支持治疗 10d ,总能量摄入为静息能量消耗 (REE)的 1 5倍 ,其中蛋白质占 2 0 % ,脂肪 30 % ,碳水化合物 5 0 %。 12例为精氨酸组 ,每天减少动物蛋白质 30g,以L 精氨酸30g替代 ,每次 10g ,3次 /d。 18例为对照组 ,观察其效果。结果 营养支持后 ,精氨酸组肱三头肌皮褶厚度、前白蛋白及体脂等营养参数较对照组明显改善 ,呼吸肌力显著提高 ,REE显著下降(P均 <0 0 5 )。结论 精氨酸不仅可改善COPD的营养状况和呼吸肌力量 ,且能显著降低患者的能量消耗 ,强化营养支持的效果 ,改善预后。

Objective To evaluate the effect of arginine in nutritional support for malnourished patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure.Methods 30 patients with COPD and respiratory failure were randomly divided into 2 groups,ie.12 patients in L-arginine supplement group and 18 patients in control group.The subjects in two groups received the same nutritional support with total calorie of 1.5 REE for ten days while L-arginine of 30 g/d was orally administered in the supplement group.Results To compare with control group,the nutritional parameters (TSF,PALB,and FM) were improved, maximal respiratory muscle strength was increased and REE was decreased significantly in L-arginine supplement group(P<0.05).Conclusions L-arginine is essential component of nutritional support in COPD which can improve nutritional conditions and reduce energy expenditure significantly.