Milla Carlos E
The Minnesota CF Center, University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA.
Curr Opin Pulm Med. 2004 Nov;10(6):505-9. doi: 10.1097/01.mcp.0000138995.08494.69.
Multiple studies have shown that nutritional status is a strong predictor of morbidity and mortality in patients with cystic fibrosis (CF). Since CF is characterized by progressive lung disease, it could be argued that the underlying lung disease is what determines the nutritional failure seen in most patients. This review will summarize the data available from studies that have attempted to better define this relation and also present a review of the possible mechanisms involved taken from both observational and interventional studies.
Longitudinal studies with sufficiently large follow-up times have demonstrated that young underweight patients have worst pulmonary function outcomes. More importantly, these studies concur in that the yearly change in growth parameters has a significant effect on the rate at which pulmonary function develops. Although the mechanisms behind this important association are yet unclear, there is some suggestion from interventional studies that the accrual of lean body mass is the factor that is involved in the preservation of lung function.
Nutritional status strongly influences pulmonary health among CF patients. Therefore, aggressive nutritional support aiming at achieving normal growth patterns should lead to adequate development of lung function and maintenance of pulmonary health. However, more research is required with long-term longitudinal studies to better identify the most critical nutritional characteristics influencing this process as well as the most effective nutritional interventions.
多项研究表明,营养状况是囊性纤维化(CF)患者发病和死亡的有力预测指标。由于CF的特征是进行性肺部疾病,因此可以认为潜在的肺部疾病是大多数患者出现营养衰竭的决定因素。本综述将总结那些试图更好地界定这种关系的研究所获得的数据,并对来自观察性研究和干预性研究的可能涉及的机制进行综述。
随访时间足够长的纵向研究表明,体重不足的年轻患者肺功能预后最差。更重要的是,这些研究一致认为生长参数的年度变化对肺功能发展速度有显著影响。尽管这种重要关联背后的机制尚不清楚,但干预性研究表明,瘦体重的增加是与肺功能维持有关的因素。
营养状况强烈影响CF患者的肺部健康。因此,旨在实现正常生长模式的积极营养支持应能促进肺功能的充分发育并维持肺部健康。然而,需要进行更多长期纵向研究,以更好地确定影响这一过程的最关键营养特征以及最有效的营养干预措施。