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目的 探讨营养支持对慢性阻塞性肺病 (COPD)急性加重期患者合并营养不良的疗效及其对免疫和肺功能的影响。方法 COPD急性加重期合并营养不良患者 6 0例 ,随机分为胃肠外营养 (PN)组及对照组 ,给予为期 2周的PN支持。结果 (1)临床疗效 :PN组有效率 93 3% ,对照组 70 0 % ,χ2 =4 0 1,P <0 0 5。 (2 )人体测量及生化检查 :PN组IBW %、TSF、MAMC及血清白蛋白明显增加。 (P <0 0 5 ) ,对照组无显著变化 (P >0 0 5 )。 (3)免疫功能检查 :PN组血TLC、CD3、CD4 、CD4 /CD8以及IgA显著性增加(P <0 0 5 ) ,对照组除血TLC显著性增加 (P <0 0 5 )外 ,其它指标无显著性变化 (P >0 0 5 )。 (4 )肺功能和血气检查 :PN组的FVC、FEV1 /FVC及PaO2 有明显改善 (P <0 0 5 ) ,对照组上述指标无显著性改变(P >0 0 5 )。结论 PN支持可以改善COPD急性加重期患者的免疫功能和肺功能 ,提高临床疗效。
Objective To investigate the effect of nutritional support on malnutrition in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and its effect on immunity and pulmonary function. Methods Sixty patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) with malnutrition were randomly divided into parenteral nutrition (PN) group and control group, and received PN support for 2 weeks. Results (1) Clinical curative effect: The effective rate of PN group was 93 3%, the control group 70 0%, χ 2 = 4 0 1, P 0 05. (2) Anthropometric and biochemical tests: IBW%, TSF, MAMC and serum albumin significantly increased in PN group. (P <0.05), no significant change in the control group (P> 0.05). (3) Immunofunction examination: The blood TLC, CD3, CD4, CD4 / CD8 and IgA were significantly increased in PN group (P <0.05), while the control group was significantly increased in blood TLC (P <0 05) No significant change in indicators (P> 0.05). (4) Pulmonary function test and blood gas examination: FVC, FEV1 / FVC and PaO2 of PN group were significantly improved (P <0.05), but there was no significant change in the control group (P> 0.05). Conclusion PN support can improve the immune function and lung function in patients with acute exacerbation of COPD and improve the clinical efficacy.