CAJ | 학술논문

目的探讨稳定期慢性阻塞性肺疾病( COPD )患者血清脂联素水平、肺功能、慢性阻塞性肺病评估测试( CAT)得分与营养状况的关系。方法收集稳定期COPD患者77例,利用CAT评分评估患者临床症状严重程度,40例同期的体检健康者作为正常对照组,按简易营养评价精法( MNA-SF)将其分为营养不良组(49例)和非营养不良组(28例),各组均行空腹血清脂联素浓度及肺功能检测。结果正常对照组脂联素浓度最高,非营养不良组血清脂联素浓度低于营养不良组,但各组间差异无统计学意义( P>0．05)；营养不良组患者的第一秒用力呼气容积( FEV1)、用力肺活量( FVC)、FEV1/FVC(用力最大肺活量百分比)、FEV1%占预计值百分比( FEV1%pred )较非营养不良组均有显著下降,差异具有统计学意义(P<0．01)；营养不良组CAT评估所得分数较非营养不良组明显下降,差异有统计学意义(P <0．01)；MNA-SF得分与FEV1、FVC、FEV1/FVC以及FEV1%pred呈显著正相关,与CAT得分呈显著负相关,与脂联素浓度无明显相关性。结论稳定期COPD患者的营养状况与FEV1/FVC、FEV1、FVC、FEV1%pred及其临床症状严重程度存在显著相关性,因而提高患者的营养状况有助于改善患者的预后和生存质量；而脂联素是否参与了COPD稳定期患者的营养不良的发生,此次研究结果尚未得到证实。
목적탐토은정기만성조새성폐질병( COPD )환자혈청지련소수평、폐공능、만성조새성폐병평고측시( CAT)득분여영양상황적관계。방법수집은정기COPD환자77례,이용CAT평분평고환자림상증상엄중정도,40례동기적체검건강자작위정상대조조,안간역영양평개정법( MNA-SF)장기분위영양불량조(49례)화비영양불량조(28례),각조균행공복혈청지련소농도급폐공능검측。결과정상대조조지련소농도최고,비영양불량조혈청지련소농도저우영양불량조,단각조간차이무통계학의의( P>0．05)；영양불량조환자적제일초용력호기용적( FEV1)、용력폐활량( FVC)、FEV1/FVC(용력최대폐활량백분비)、FEV1%점예계치백분비( FEV1%pred )교비영양불량조균유현저하강,차이구유통계학의의(P<0．01)；영양불량조CAT평고소득분수교비영양불량조명현하강,차이유통계학의의(P <0．01)；MNA-SF득분여FEV1、FVC、FEV1/FVC이급FEV1%pred정현저정상관,여CAT득분정현저부상관,여지련소농도무명현상관성。결론은정기COPD환자적영양상황여FEV1/FVC、FEV1、FVC、FEV1%pred급기림상증상엄중정도존재현저상관성,인이제고환자적영양상황유조우개선환자적예후화생존질량；이지련소시부삼여료COPD은정기환자적영양불량적발생,차차연구결과상미득도증실。
Objective To explore the relationship between the level of serum adiponection, lung fuction, CAT scores and malnutrition in stable COPD patients. Methods Seventy-seven stable COPD patients who completed COPD assessment test( CAT) and forty healthy controls participated in the study. COPD patients were divided into two groups according to MNA-SF scores:49 cases in malnutrition group and 28 cases in eutrophic group. The serum adiponection was measured and pulmonary function teste was conducted. Results The level of the serum adiponec-tion in the control group was higher than those of the other two groups. The level of serum adiponection in the eu-trophic group was lower than those of the malnutrition group, but there was no statistical difference in three groups (P>0. 05). The levels of the FEV1,FVC, FEV1/FVC and FEV1%pred in the malnutrition group was lower than those of the eutrophic group with a significant difference ( P<0. 01 ) . The CAT scores in the malnutrition group were significantly lower than those of the eutrophic group ( P<0. 01 ) . MNA-SF scores showed a positive correlation with FEV1,FVC,FEV1/FVC and FEV1%pred,a significant inversely correlation was observed between MNA-SF scores and CAT scores, serum adiponection was not significantly correlated with MNA-SF scores. Conclusion The malnutrition of COPD patients in stable stage has a significant correlation with their FEV1, FVC, FEV1/FVC, FEV1%pred and clinical symptoms. To improve the nutrition states of COPD patients in stable stage is helpful for their prognosis and quality of life. But the relationship between adiponection and malnutrition of COPD patients has not been demonstrated.