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目的：为探讨加强营养支持对高原地区肺心病缓解期营养不良患者呼吸和免疫功能的作用；方法：对３０例高原（海拔２２６０～３２００ｍ）慢性肺心病缓解期营养不良（ＮＤ）患者在加强营养支持前后作了肺功能、吸气肌功能、动脉血气、血清免疫球蛋白和补体测定，并与本地肺心病营养正常（ＮＮ）患者对比；结果：ＮＤ组三头肌皮肤皱褶厚度（ＴＳＦ）、上臂中部周径（ＭＡＭＣ）、口腔最大吸气压（ＰＩｍａｘ）、最大跨膈压（Ｐｄｉｍａｘ）、ＰａＯ２、ＩｇＡ、Ｃ３、Ｃ４均明显低于ＮＮ组（Ｐ均＜０．０１），膈肌张力—时间指数（ＴＴｄｉ）和ＰａＣＯ２明显高于ＮＮ组（Ｐ均＜０．０１），两组ＦＥＶ１．０、ＩｇＧ、ＩｇＭ无差异性。ＮＤ组加强营养支持６周后，体重明显增加，ＴＳＦ、ＭＡＭＣ、ＰＩｍａｘ、Ｐｄｉｍａｘ、ＰａＯ２、ＩｇＡ、Ｃ３、Ｃ４明显提高（Ｐ＜０．０１或＜０．０５），ＴＴｄｉ，ＰａＣＯ２明显下降（Ｐ＜０．０１）；结论：加强营养支持治疗能明显改善高原地区肺心病营养不良患者的呼吸功能和增强其免疫功能。
Objective: To investigate the effect of enhancing nutrition support on respiratory and immune function of malnutrition patients in remission stage of pulmonary heart disease in plateau area.Methods: 30 patients with malnutrition (ND) in remission stage of chronic cor pulmonale at altitude of 2260 ~ 3200m The pulmonary function, inspiratory muscle function, arterial blood gas, serum immunoglobulin and complement determination were compared before and after the support, and compared with the normal nutrition (NN) in local patients with pulmonary heart disease.Results: The skin fold thickness (TSF) MAMC, PImax, Pdimax, PaO2, IgA, C3 and C4 were significantly lower in NN group than those in NN group (P <0.01). Diaphragm tension The time index (TTdi) and PaCO2 were significantly higher than those in NN group (all P <0.01). There was no difference in FEV1.0, IgG and IgM between the two groups. After six weeks of intensive nutrition support, ND group increased body weight significantly, TSF, MAMC, PImax, Pdimax, PaO2, IgA, C3 and C4 significantly increased (P <0.01 or < <0.01). CONCLUSION: Strengthening nutritional support therapy can significantly improve the respiratory function and enhance the immune function of patients with pulmonary heart disease malnutrition in the plateau area.