PREVALENCE AND CHARACTERISTICS OF NUTRITIONAL DEPLETION IN PATIENTS WITH STABLE COPD ELIGIBLE FOR PULMONARY REHABILITATION
PREVALENCE AND CHARACTERISTICS OF NUTRITIONAL DEPLETION IN PATIENTS WITH STABLE COPD ELIGIBLE FOR PULMONARY REHABILITATION
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DOI：
10.1164/ajrccm/147.5.1151
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发表时间：
1993-05-01
期刊：
影响因子：
--
通讯作者：
WOUTERS, EFM
中科院分区：
文献类型：
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作者：
SCHOLS, AMWJ;SOETERS, PB;WOUTERS, EFM
通过测量255例在肺康复中心住院的临床病情稳定的COPD患者的身体成分，确定营养耗竭的患病率和特征。体重、去脂质量（使用生物电阻测量）和肌肉质量[根据肌酐身高指数（CHI）和上臂肌围]的消耗在慢性低氧血症患者和重度气流阻塞（FEV 1 < 35%）的血氧正常患者中最为明显（40 - 50%），但也发生在+/- 25%的中度气流阻塞患者中。按体重和去脂质量将患者分为四组，结果显示，正常体重COPD患者可能出现去脂质量耗竭（第3组）。这些患者还表现出CHI降低（61 +/-21%，平均值+/- SD），并且遭受身体损害（12分钟步行距离，WD，532 +/- 152 m），其程度甚至大于相对保留无脂肪质量的体重不足患者（第2组）（CHI = 73 +/- 16%; WD = 744 +/- 233 m）。在血清蛋白浓度或药物使用方面，四组之间没有系统性差异。我们的结论是，无脂肪质量是一个更好的指标，身体质量消耗比体重。COPD患者按体重和去脂质量分类可能对干预策略的计划和解释产生影响，特别是在第2组和第3组患者中。
Prevalence and characteristics of nutritional depletion were established by body composition measurements in 255 COPD patients in stable clinical condition admitted to a pulmonary rehabilitation center. Depletion of body weight, fat-free mass (using bioelectrical resistance measurements), and muscle mass [from creatinine height index (CHI) and midarm muscle circumference] was most pronounced (40 to 50%) in patients suffering from chronic hypoxemia and in normoxemic patients with severe airflow obstruction (FEV1 < 35%) but also occurred in +/- 25% of patients with moderate airflow obstruction. Classification of the patients in four groups by body weight and fat-free mass revealed that depletion of fat-free mass may occur in normal-weight COPD patients (Group 3). These patients also exhibit a decreased CHI (61 +/- 21%, mean +/- SD) and suffer from physical impairment (12-min walking distance, WD, 532 +/- 152 m) to an even greater degree than underweight patients with relative preservation of fat-free mass (Group 2) (CHI = 73 +/- 16%; WD = 744 +/- 233 m). No systematic differences were established between the four groups in serum protein concentrations or medication use. We conclude that fat-free mass is a better indicator of body mass depletion than body weight. Classification of COPD patients by body weight and fat-free mass may have consequences for planning and interpretation of intervention strategies, particularly in Group 2 and 3 patients.