【摘要】 很多慢性阻塞性肺病（COPD）患者在病程中体重持续明显下降。本研究是为研究病情稳定的80例COPD患者（年龄:65±3岁,肺功能FEV₁（第一秒用力呼气肺活量:1.0=0.1L）的能量摄入和静息能量消耗对消瘦的作用 80例中39例在研究开始前一年体重已有进行性下降。体重逐渐明显持续下降患者的静息能量消耗（117—3）。明显地高于体重稳定的患者（108±2%）.静息能量消耗值以占无脂群表示（REE FFM-BI）时体重逐渐明显持续下降患者的数值（35.0±0.8%）也明显地高于体重稳定的患者（133.1±2.5kJ kg）。能量摄入在体重明显持续下降和体重稳定的COPD患者间无明显差异。（REE FFM-BI）与FEV（r-0.48,P<0.05）。最大呼吸口腔压（Plmax,r=0.35,P<0.01）及每公斤无脂群的能量摄入（Eintake FFM-BI）（r=0.48,P<0.001）显著相关.按病况的严重性分组时,1组FEV₁>35%,2组FEV₁≤35%, 3组PaO₂<7.3kPa）。显示了在体重下降的低氧血症患者组中,其能量摄入明显减少,一些人体测量指标的下降也与患者病况的严重性显著相关。更多还原

【Abstract】 A substantial number of patients with chronic obstructive pulmonary disease(COPD) suffer from gradual and significant weight loss during the natural course of their illness. The aim of this study was to determine the contribution of resting energy expenditure (REE) and energy intake(E-intake) to weight loss in 80 patients with table COPD: age (mean±SEM) 65±3 yr and FEV 1. 0- 0. 1 L. A total of 39 patients exhibited a continued weight loss in the previous year. REE measured with a ventilated hood system was significantly ( P <0. 005) higher in weight-losing compared to weight-stable patients when values were nor-malized for predicted metabolic rate( 117 ±3% and 108±2%, respectively) or kg fat-free mass using bio-electrical impedance (FFM-B1:35. 0± 0. 8and 31. 8 ± 0. 6kcal/kg, respectivel).Normalized values of E-intake were not significantly different between weyght-losing and weight-stable patients. REE/FFM-B1 correlated significantly with FEV1 ( r = 0. 02, P <0. 05), maximal inspiratory mouth pressure (P1max; r =0. 35, P <0. 001) .and E-intake/FFM-B1(r = 0. 48, P<0.001). Classification in three subgroups by seventy of disease, (1)FEV1>35% , (2)FEV1≤35 % , and (3)PaO2<7. 3kPa, revealed a higher prevalence of weight loss in the more compromised groups and a significantly decueased( P <0. 05). E-intake in the hypoxemic patients. A gradual depletion of percentage ideal body weight( P <0. 001 ). midarm circumference( P <0. 01 ),midarm muscle circumference ( P <0. 001). and creatinine heighe index( P <0. 001 ), and creatinine height index( P<0. 01 ) and a decrease in respiratory muscle strength ( P <0. 005) were associated with increasing severity of disease. Our results indicate that a failure of an adaptive response to undernutrition and inadequate dietary intake for energy expenditure are two contributing factors to weight loss in COPD.更多还原