CAJ | 학술논문

目的：应用多频生物电阻抗技术分析 COPD 患者人体成分及其与血气分析指标的关系，为 COPD 患者的营养支持提供依据。方法选择2011年1—6月在新桥医院呼吸科住院并诊断为 COPD 患者62例，采用多频生物电阻抗法检测患者的人体成分，收集患者入院时的血清总蛋白、清蛋白、前清蛋白、血红蛋白、淋巴细胞计数及血气分析指标〔二氧化碳分压（PaCO2）、氧分压（PaO2）、血氧饱和度（SpO2）、HCO -3、Cl -、K ＋、Na ＋、pH 值〕，对相关指标进行统计分析。结果依据体蛋白质含量、体脂肪量（BFM）、体质指数（BMI）、上臂围（MAC）4种指标评价COPD 患者的营养状况，营养不足率分别为41.9％、17.7％、19.4％、16.1％。以 BMI 为分组标准，不同营养状况分组患者身体总水分（TBW）、BFM、体脂率（PBF）、无脂组织（FFM）、无脂肪组织体质量比（ PBFF）、体蛋白质含量、蛋白质体质量比（PBP）比较，差异均有统计学意义（P ＜0.05），其中营养不足组 PBP 高于营养正常组和营养过剩组，营养不足组 PBF 和 FFM 低于营养正常组和营养过剩组（ P ＜0.05）。TBW、FFM、体蛋白质含量、骨骼肌（SMM）与 PaO2呈负相关（ r ＝-0.311、-0.306、-0.308、-0.306，P ＜0.05），BMI 与 SpO2呈负相关（ r ＝-0.304，P ＜0.05）。结论依据体蛋白质含量评估 COPD 患者的营养不足率较高。相对于 BMI 常规营养评价指标， FFM 指标对 COPD 患者的营养状况评价更为敏感，并提示增加 COPD 患者 FFM 含量可能有益于提高其缺氧耐受性。
목적：응용다빈생물전조항기술분석 COPD 환자인체성분급기여혈기분석지표적관계，위 COPD 환자적영양지지제공의거。방법선택2011년1—6월재신교의원호흡과주원병진단위 COPD 환자62례，채용다빈생물전조항법검측환자적인체성분，수집환자입원시적혈청총단백、청단백、전청단백、혈홍단백、림파세포계수급혈기분석지표〔이양화탄분압（PaCO2）、양분압（PaO2）、혈양포화도（SpO2）、HCO -3、Cl -、K ＋、Na ＋、pH 치〕，대상관지표진행통계분석。결과의거체단백질함량、체지방량（BFM）、체질지수（BMI）、상비위（MAC）4충지표평개COPD 환자적영양상황，영양불족솔분별위41.9％、17.7％、19.4％、16.1％。이 BMI 위분조표준，불동영양상황분조환자신체총수분（TBW）、BFM、체지솔（PBF）、무지조직（FFM）、무지방조직체질량비（ PBFF）、체단백질함량、단백질체질량비（PBP）비교，차이균유통계학의의（P ＜0.05），기중영양불족조 PBP 고우영양정상조화영양과잉조，영양불족조 PBF 화 FFM 저우영양정상조화영양과잉조（ P ＜0.05）。TBW、FFM、체단백질함량、골격기（SMM）여 PaO2정부상관（ r ＝-0.311、-0.306、-0.308、-0.306，P ＜0.05），BMI 여 SpO2정부상관（ r ＝-0.304，P ＜0.05）。결론의거체단백질함량평고 COPD 환자적영양불족솔교고。상대우 BMI 상규영양평개지표， FFM 지표대 COPD 환자적영양상황평개경위민감，병제시증가 COPD 환자 FFM 함량가능유익우제고기결양내수성。
Objective To examine the body composition of COPD patients by multi - frequency bioelectrical impedance and investigate the relationship between body composition and blood gas indicators in order to provide clinical references for nutritional support for COPD patients. Methods We enrolled 62 patients who was hospitalized and diagnosed with COPD in the Department of Respiratory Medicine of Xinqiao Hospital from January to June in 2011. Multi - frequency bioelectrical impedance was used to detect the patients' physical composition. We collected data of serum total protein,albumin, prealbumin,hemoglobin,lymph cell count,blood gas( PaCO2 ,PaO2 and SpO2 ),HCO -3 ,Cl - ,K + ,Na + ,pH of the subjects at admission. Statistical analysis was conducted on the above indicators. Results The malnutrition rates assessed by ribosomal protein content,body fat content,BMI and MAC were 41. 9% ,17. 7% ,19. 4% and 16. 1% , respectively. According the BMI,the patients with inadequate,normal and excess nutrition were significantly different( P < 0. 05 )in ribosomal TBW,BFM,PBF,FFM,PBFF,protein content and PBP;the subjects with inadequate nutrition were higher(P <0. 05)than those with normal and high nutrition in PBP;the subjects with inadequate nutrition were lower( P < 0. 05)than those with normal and high nutrition in PBF and FFM. TBW,FFM,ribosomal protein,and SMM were negatively correlated with PaO2 ( r = - 0. 311, - 0. 306, - 0. 308, - 0. 306;P < 0. 05),and BMI was negatively correlated with SpO2 ( r =- 0. 304,P < 0. 05). Conclusion COPD patients have high malnutrition rate when assessed by ribosomal protein. FFM is more sensitive than BMI in nutritional evaluation of COPD patients. The increase of FFM in COPD patients may improve hypoxia tolerance.