国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2013年
21期
1622-1627
,共6页
慢性阻塞性肺疾病%吸气分数%低密度脂蛋白胆固醇
慢性阻塞性肺疾病%吸氣分數%低密度脂蛋白膽固醇
만성조새성폐질병%흡기분수%저밀도지단백담고순
Chronic obstructive pulmonary disease%Inspiratory fraction%Low-density lipoprotein cholesterol
目的 探讨慢性阻塞性肺疾病急性加重(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)患者静态肺过度充气与营养状态的相互关系.方法 收集2010年7月至2011年7月在首都医科大学附属北京朝阳医院呼吸科住院诊治的AECOPD患者108例,其中男75例,女33例,年龄48～89岁,中位数72岁.住院期间对所有患者进行肺功能和多项营养参数检测,并根据吸气分数(inspiratory capacity/total lung capacity,IC/TLC)将其分为静态肺过度充气组(IC/TLC＜0.25)和非静态肺过度充气组(IC/TLC≥0.25),对两组间结果进行比较.结果 与无静态肺过度充气的患者相比,存在静态肺过度充气的AECOPD患者具有更高的吸烟指数(20.5包·年vs 30包·年,P=0.048)、更严重的气流阻塞程度[FEV1％pred,(58.4±23.1)％ vs(36.4±14.1)％,P＜0.001]和更低的氧气弥散能力[DLCO/VA％pred,(65.4±28.3)％ vs (44.1±27.7)％,P＜0.001].存在静态肺过度充气的AECOPD患者血清低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDLc)的水平低于无静态肺过度充气者[(2.36±0.71) mmol/L vs (2.66±0.74) mmol/L,P=0.042].IC/TLC的比值与患者血清LDLc的水平呈正相关(r=0.29,P=0.002),且IC/TLC比值每降低1％,LDLc水平就随之降低约0.02 mmol/L.两组患者在血清白蛋白、前白蛋白、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、血肌酐、肌酸激酶水平上的差异均无统计学意义.结论 AECOPD患者的血清LDLc水平降低与静态肺过度充气程度相关,推测LDLc可能是早期筛查AECOPD患者营养不良的一个敏感指标.
目的 探討慢性阻塞性肺疾病急性加重(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)患者靜態肺過度充氣與營養狀態的相互關繫.方法 收集2010年7月至2011年7月在首都醫科大學附屬北京朝暘醫院呼吸科住院診治的AECOPD患者108例,其中男75例,女33例,年齡48～89歲,中位數72歲.住院期間對所有患者進行肺功能和多項營養參數檢測,併根據吸氣分數(inspiratory capacity/total lung capacity,IC/TLC)將其分為靜態肺過度充氣組(IC/TLC＜0.25)和非靜態肺過度充氣組(IC/TLC≥0.25),對兩組間結果進行比較.結果 與無靜態肺過度充氣的患者相比,存在靜態肺過度充氣的AECOPD患者具有更高的吸煙指數(20.5包·年vs 30包·年,P=0.048)、更嚴重的氣流阻塞程度[FEV1％pred,(58.4±23.1)％ vs(36.4±14.1)％,P＜0.001]和更低的氧氣瀰散能力[DLCO/VA％pred,(65.4±28.3)％ vs (44.1±27.7)％,P＜0.001].存在靜態肺過度充氣的AECOPD患者血清低密度脂蛋白膽固醇(low-density lipoprotein cholesterol,LDLc)的水平低于無靜態肺過度充氣者[(2.36±0.71) mmol/L vs (2.66±0.74) mmol/L,P=0.042].IC/TLC的比值與患者血清LDLc的水平呈正相關(r=0.29,P=0.002),且IC/TLC比值每降低1％,LDLc水平就隨之降低約0.02 mmol/L.兩組患者在血清白蛋白、前白蛋白、總膽固醇、高密度脂蛋白膽固醇、甘油三酯、血肌酐、肌痠激酶水平上的差異均無統計學意義.結論 AECOPD患者的血清LDLc水平降低與靜態肺過度充氣程度相關,推測LDLc可能是早期篩查AECOPD患者營養不良的一箇敏感指標.
목적 탐토만성조새성폐질병급성가중(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)환자정태폐과도충기여영양상태적상호관계.방법 수집2010년7월지2011년7월재수도의과대학부속북경조양의원호흡과주원진치적AECOPD환자108례,기중남75례,녀33례,년령48～89세,중위수72세.주원기간대소유환자진행폐공능화다항영양삼수검측,병근거흡기분수(inspiratory capacity/total lung capacity,IC/TLC)장기분위정태폐과도충기조(IC/TLC＜0.25)화비정태폐과도충기조(IC/TLC≥0.25),대량조간결과진행비교.결과 여무정태폐과도충기적환자상비,존재정태폐과도충기적AECOPD환자구유경고적흡연지수(20.5포·년vs 30포·년,P=0.048)、경엄중적기류조새정도[FEV1％pred,(58.4±23.1)％ vs(36.4±14.1)％,P＜0.001]화경저적양기미산능력[DLCO/VA％pred,(65.4±28.3)％ vs (44.1±27.7)％,P＜0.001].존재정태폐과도충기적AECOPD환자혈청저밀도지단백담고순(low-density lipoprotein cholesterol,LDLc)적수평저우무정태폐과도충기자[(2.36±0.71) mmol/L vs (2.66±0.74) mmol/L,P=0.042].IC/TLC적비치여환자혈청LDLc적수평정정상관(r=0.29,P=0.002),차IC/TLC비치매강저1％,LDLc수평취수지강저약0.02 mmol/L.량조환자재혈청백단백、전백단백、총담고순、고밀도지단백담고순、감유삼지、혈기항、기산격매수평상적차이균무통계학의의.결론 AECOPD환자적혈청LDLc수평강저여정태폐과도충기정도상관,추측LDLc가능시조기사사AECOPD환자영양불량적일개민감지표.
Objective Air trapping leads to a reduction in inspiratory capacity / total lung capacity (IC/TLC) ratio in patients with chronic obstructive pulmonary disease(COPD).Knowledge of the effects of low IC/TLC ratio (IC/TLC ＜ 0.25) on nutritional status and respiratory impairment during acute exacerbations of COPD (AECOPD) is limited.Methods In 108 patients admitted to the hospital due to an AECOPD (75 men; median age,72 years [interquartile range (IQR),65 to 76 years]; FEV1 ％pred,(44.5±20.8) ％),we measured pulmonary function (body plethysmograph),BMI and nutritional parameters,including serum albumin,prealbumin,cholesterol,triglycerides,high-density lipoprotein cholesterol (HDLc),low-density lipoprotein cholesterol (LDLc),creatinine and creatine kinase (CK).Results Patients with low IC/TLC ratio (＜0.25) had significantly greater pack-years of smoking,and lower FEV1,FEV1/FVC,and DLCO/VA.Lower serum LDLc levels were seen in group with low IC/TLC ratio compared to those patients with IC/TLC≥0.25 [(2.36±0.71) mmol/L vs (2.66±0.74)mmol/L,P =0.042].The decrease in IC/TLC ratio correlated positively with serum LDLc levels (r =0.29,P =0.002),and with the reduction of IC/TLC by every 1％,the change in LDLc was 0.02 mmol/L.No differences were observed in serum albumin,prealbumin,cholesterol,triglycerides,HDLc,creatinine and CK between both groups.Conclusions In patients with AECOPD,low IC/TLC is associated with lower serum LDLc levels,suggesting LDLc may be a promising marker for the detection of early malnutrition.
