Pieters T, Boland B, Beguin C, Veriter C, Stanescu D, Frans A, Lambert M
Pneumology Unit, General Internal Medicine Division and Medical Information Division, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10 B-1200 Brussels, Belgium.
J Intern Med. 2000 Aug;248(2):137-42. doi: 10.1046/j.1365-2796.2000.00712.x.
In humans, malnutrition alters the respiratory system in different ways. It impairs the ventilatory drive, decreases respiratory muscle strength and reduces immune competence. In addition, typical emphysema-like changes were demonstrated in starved animals. The presence of emphysema has never been demonstrated in starved humans. Our objective was to investigate whether pulmonary emphysema occurs in anorexia nervosa by means of a pulmonary function study.
We examined 24 women aged between 14 and 38 years (nine smokers). We studied the lung function including lung volumes, ventilatory capacity, maximal respiratory pressures and transfer factor, as well as PaO2.
All respiratory tests were within normal limits with the exception of decreased maximal inspiratory (59% of predicted values) and expiratory pressures (35%), and increased residual volume (162%). Diffusion capacity (98.1 +/- 16.2%) and transfer coefficient (98.4 +/- 16.2%) were also normal. The diffusion coefficient was lower in current smokers than in those who had never smoked (P < 0.01), a difference similar to that calculated from existing reference values for transfer factor for smokers and nonsmokers.
In anorexia nervosa, pulmonary function tests are within normal limits with the exception of maximal pressures and residual volume. Diffusion capacity is not decreased. The present results within the limitations of the used method are not compatible with the hypothesis of starvation-induced pulmonary emphysema.
在人类中，营养不良会以不同方式改变呼吸系统。它会损害通气驱动，降低呼吸肌力量并削弱免疫能力。此外，在饥饿动物中已证实存在典型的类肺气肿改变。但从未在饥饿的人类中证实过肺气肿的存在。我们的目的是通过肺功能研究调查神经性厌食症患者是否会发生肺气肿。
我们检查了24名年龄在14至38岁之间的女性（9名吸烟者）。我们研究了肺功能，包括肺容积、通气能力、最大呼吸压力和转运因子，以及动脉血氧分压（PaO2）。
除最大吸气压力（为预测值的59%）和呼气压力降低（35%）以及残气量增加（162%）外，所有呼吸测试均在正常范围内。弥散能力（98.1±16.2%）和转运系数（98.4±16.2%）也正常。当前吸烟者的弥散系数低于从不吸烟者（P<0.01），这一差异与根据现有吸烟者和非吸烟者转运因子参考值计算出的差异相似。
在神经性厌食症中，除最大压力和残气量外，肺功能测试均在正常范围内。弥散能力未降低。在所使用方法的局限性范围内，目前的结果与饥饿诱导肺气肿的假设不相符。
