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目的:观察营养支持对慢性阻塞性肺疾病(COPD)病人营养状况的影响,探讨其相关因素。方法:将120例COPD病人分为研究组和对照组,研究组60例伴营养不良,对照组60例营养状况正常。两组COPD病人分别给予等氮、等热量的营养支持;60名健康人为正常对照组,自由膳食。于营养支持前、后分别测体质指数(BMI)、血清总蛋白(TB)、清蛋白(ALB)、前清蛋白(PA)、瘦素(Leptin)和抵抗素(RS)等水平,进一步分析营养指标与瘦素、抵抗素的关系。结果:与对照组比,研究组在营养支持前和营养支持第7天的BMI、TB、ALB下降明显(P<0.05);瘦素水平明显升高(P<0.05),RS水平有升高趋势,但无显著性差异(P>0.05);第12天,三组间BMI、TB、ALB、PA、瘦素、RS水平比较差异无显著性意义(P>0.05)。与营养治疗前比,研究组病人TB水平明显升高、瘦素水平明显下降(P<0.05)。多元逐步回归分析显示,BMI、TB、ALB、PA与瘦素显著相关(P<0.05)、与RS相关不显著(P>0.05)。结论:营养支持可明显改善COPD病人的营养状况,血清瘦素与BMI、TB、ALB成负相关,血清瘦素是COPD病人营养不良的危险因素。
Objective: To observe the effect of nutritional support on nutritional status of patients with chronic obstructive pulmonary disease (COPD) and to explore its related factors. Methods: 120 COPD patients were divided into study group and control group. 60 cases in research group were malnourished while 60 cases in control group were normal nutrition status. Two groups of COPD patients were given equal nitrogen, calorie nutrition support; 60 healthy people as normal control group, free diet. The levels of BMI, ALB, ALB, Leptin and resistin (RS) were measured before and after nutritional support. Nutritional indicators and leptin, resistin relationship. Results: Compared with the control group, the BMI, TB and ALB decreased significantly (P <0.05) before the nutritional support and on the 7th day of nutrition support in the research group, the leptin level increased significantly (P <0.05) and the RS level increased (P> 0.05). There was no significant difference in BMI, TB, ALB, PA, leptin and RS between the three groups on the 12th day (P> 0.05). Compared with the nutrition before treatment, the study group patients with TB increased significantly, leptin levels decreased significantly (P <0.05). Multivariate stepwise regression analysis showed that BMI, TB, ALB, PA were significantly associated with leptin (P <0.05), but not with RS (P> 0.05). Conclusion: Nutritional support can significantly improve the nutritional status of patients with COPD, serum leptin and BMI, TB, ALB negatively correlated, serum leptin is a risk factor for malnutrition in COPD patients.