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目的 探讨营养状态对慢性阻塞性肺疾病 (COPD)患者运动心肺功能的影响。方法 4 3例COPD患者分为营养不良组 (15例 ) ,营养正常组 (2 8例 )和健康志愿者 (2 0名 )进行负荷连续递增的运动心肺功能试验。运动前行营养评价和常规肺功能检查。结果 (1)COPD营养不良组最大氧耗量 ( VO2 max)、最大运动负荷 (Wmax)、最大氧脉搏 (O2 pulsemax)和无氧阈 (AT)低于营养正常组 ,两组比较差异有显著性 (P <0 0 5 ) ;通气氧耗 ( VO2 /W/ VE)和最大运动时的气急指数 (DImax)与营养正常组比较 ,差异有显著性 (P <0 0 5 )。 (2 )COPD患者理想体重百分比 (IBW % )与 VO2 max占预计值百分比、Wmax占预计值百分比、O2 pulsemax占预计值百分比、AT呈正相关 (r=0 6 96 ,0 4 32 ,0 717,0 82 2 ,P均<0 0 1) ,与DImax、 VO2 /W/ VE 呈负相关 (r=- 0 4 5 0 ,- 0 6 4 0 ,P均 <0 0 1)。结论 营养不良可以导致COPD患者肌肉有氧代谢能力和运动耐力降低。
Objective To investigate the effects of nutritional status on exercise cardiopulmonary function in patients with chronic obstructive pulmonary disease (COPD). Methods 4 3 COPD patients were divided into malnourished group (n = 15), normotensive group (n = 28) and healthy volunteers (n = 20) for continuous exercise cardiopulmonary function test. Exercise nutrition evaluation and routine pulmonary function tests. Results (1) The maximum oxygen consumption (VO2max), maximum exercise load (Wmax), maximum oxygen pulse (O2 pulsemax) and anaerobic threshold (AT) in COPD malnutrition group were lower than those in normal nutrition group (P <0 05). VO2 / W / VE and DImax were significantly higher than those of normal nutrition group (P <0.05). (2) The percentage of predicted body weight (IBW%) and VO2 max in patients with COPD, the percentage of predicted value of Wmax, the percentage of predicted value of O2 pulsemax, and AT were positively correlated (r = 0 6 96, 0 4 32, 0 717, 0 82 2, P <0 0 1), and negatively correlated with DImax and VO2 / W / VE (r = - 0 4 5 0, - 0 6 4 0, all P <0 0 1). Conclusion Malnutrition can result in decreased muscle aerobic metabolism and exercise tolerance in COPD patients.