Nutritional rehabilitation: from pulmonary cachexia to sarcoPD
Nutritional rehabilitation: from pulmonary cachexia to sarcoPD
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营养康复：从肺恶病质到肌病
DOI：
10.1183/09031936.00011209
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发表时间：
2009
影响因子：
24.3
通讯作者：
A. Schols
中科院分区：
文献类型：
--
作者：
A. Schols
越来越多的证据表明，慢性阻塞性肺疾病（COPD）的疾病负担不仅取决于肺功能损害，而且还取决于骨骼肌病理学和心血管疾病也会导致体能下降和死亡率增加。在COPD管理中，将多器官功能下降作为吸烟、次优饮食、不活动和疾病易感性导致的稳态网络紊乱的综合观点尚未被概念化，但可能导致临床医学和公共卫生向个性化生活方式转变。
研究肺恶病质中骨骼肌病理的发病机制和治疗以减轻进行性残疾一直是过去十年中深入研究的主题。虽然多模式营养康复策略的合成代谢和代谢潜力，包括运动，蛋白质-卡路里补充，多不饱和脂肪酸和/或合成代谢剂，已在短期1-3中得到证实，但由于缺乏长期策略来维持晚期疾病的身体健康以及持续炎症对肺恶病质的不良影响，肺恶病质的疗效受到限制。
Evidence is accumulating that disease burden in chronic obstructive pulmonary disease (COPD) is determined by not only pulmonary impairment but the fact that skeletal muscle pathology and cardiovascular disease also contribute to decreased physical performance and increased mortality. An integrated view of the decline in function of multiple organs as a disturbed homeostatic network resulting from smoking, suboptimal diet, inactivity and disease susceptibility has not yet been conceptualised in COPD management but could lead to a shift in clinical medicine and public health towards personalised lifestyle.
Research into the pathogenesis and treatment of skeletal muscle pathology in pulmonary cachexia to alleviate progressive disability has been the subject of intensive research during the past decade. While the anabolic and metabolic potential of multimodal nutritional rehabilitation strategies, including exercise, protein-calorie supplementation, polyunsaturated fatty acids and/or anabolic agents, has been demonstrated in the short-term 1–3, efficacy in pulmonary cachexia is limited by the absence of long-term strategies to maintain physical fitness in advanced disease and by adverse effects of persistent inflammation on …