Kotler D P
Department of Medicine, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, NY 10025.
J Nutr. 1992 Mar;122(3 Suppl):723-7. doi: 10.1093/jn/122.suppl_3.723.
Studies of body composition in acquired immunodeficiency syndrome (AIDS) patients demonstrated body cell mass depletion out of proportion to losses of body weight or fat. The timing of death from wasting was related to the extent rather than the specific cause. However, some patients remain stable for indefinite periods, indicating that wasting is not a constant phenomenon. The development of malnutrition is multifactorial and includes disorders of food intake, nutrient absorption and intermediary metabolism. Nutritional repletion has been demonstrated in several studies. The effect of treating infections that promote wasting was shown in a study of ganciclovir therapy for cytomegalovirus colitis, in which untreated patients underwent progressive wasting whereas treated patients repleted body mass. Total parenteral nutrition had a variable effect upon body composition, with repletion occurring in patients with eating disorders or malabsorption syndromes and progressive depletion occurring in patients with serious systemic infections. Enteral nutrition also can replete body mass in AIDS patients without severe malabsorption. Pharmacologic stimulation of appetite also may lead to weight gain. The results of these studies indicate that nutritional support can improve nutritional status in properly selected AIDS patients.
对获得性免疫缺陷综合征（艾滋病）患者身体成分的研究表明，体细胞质量的消耗与体重或脂肪的减少不成比例。因消瘦而死亡的时间与程度有关，而非具体病因。然而，一些患者可在不确定的时期内保持稳定，这表明消瘦并非一种持续存在的现象。营养不良的发生是多因素的，包括食物摄入、营养吸收及中间代谢的紊乱。多项研究已证实营养补充的作用。一项关于更昔洛韦治疗巨细胞病毒性结肠炎的研究显示了治疗促进消瘦的感染的效果，其中未经治疗的患者逐渐消瘦，而接受治疗的患者体重增加。全胃肠外营养对身体成分的影响各不相同，饮食失调或吸收不良综合征患者会出现体重增加，而严重全身感染患者则会出现进行性消瘦。对于没有严重吸收不良的艾滋病患者，肠内营养也可使体重增加。药物刺激食欲也可能导致体重增加。这些研究结果表明，营养支持可改善适当选择的艾滋病患者的营养状况。
