Görek Dilektaşli Asli, Ulubay Gaye, Bayraktar Nilüfer, Eminsoy Irem, Oner Eyüboğlu Füsun
Department of Chest Diseases, Faculty of Medicine, Başkent University, Ankara, Turkey.
Tuberk Toraks. 2009;57(3):298-305.
Malnutrition is an important problem in patients with chronic obstructive pulmonary disease (COPD). It still remains unclear whether malnutrition contributes to poor pulmonary function through a loss of respiratory muscle mass, or if advanced disease and hypoxemia are the causes of weight loss and malnutrition in COPD patients. This study was made to examine the effects of malnutrition on pulmonary function tests (PFTs) in COPD patients. With this purpose 35 stable COPD patients were enrolled in this study. According to their body mass indexes, the subjects were divided in two groups (group 1: cachectic and group 2: non-cachectic). All subjects were performed PFTs, serum tumor necrosis factor-alpha (TNF-alpha) levels, resting energy expenditure (REE), nutrition parameters, and arterial blood gas tension. PFTs were impaired to a greater degree in cachectic than non-cachectic patients. Serum TNF-alpha levels and REE were higher in cachectic patients than in non-cachectic patients. Significant correlations were observed among PFTs, REE, and serum TNF-alpha level. Furthermore there was a significant correlation between serum albumin level and PFTs. This study demonstrated that cachexia had a negative effect on PFTs in patients with COPD. Additionally, our study showed that serum protein levels can affect airway function and diffusing capacity of lungs in COPD. Another result of this study was that; increased REE and serum TNF-alpha levels could contribute to weight loss in patients with COPD. Further studies are needed to demonstrate the effect of nutritional supplementation containing essential amino acids on PFTs in these patients.
营养不良是慢性阻塞性肺疾病（COPD）患者的一个重要问题。目前仍不清楚营养不良是通过呼吸肌质量的丧失导致肺功能不佳，还是晚期疾病和低氧血症是COPD患者体重减轻和营养不良的原因。本研究旨在探讨营养不良对COPD患者肺功能测试（PFT）的影响。为此，35名稳定期COPD患者纳入本研究。根据体重指数，将受试者分为两组（第1组：恶病质组和第2组：非恶病质组）。所有受试者均进行了肺功能测试、血清肿瘤坏死因子-α（TNF-α）水平、静息能量消耗（REE）、营养参数和动脉血气张力测定。恶病质患者的肺功能测试受损程度比非恶病质患者更大。恶病质患者的血清TNF-α水平和REE高于非恶病质患者。在肺功能测试、REE和血清TNF-α水平之间观察到显著相关性。此外，血清白蛋白水平与肺功能测试之间存在显著相关性。本研究表明，恶病质对COPD患者的肺功能测试有负面影响。此外，我们的研究表明，血清蛋白水平可影响COPD患者的气道功能和肺弥散能力。本研究的另一个结果是，REE增加和血清TNF-α水平升高可能导致COPD患者体重减轻。需要进一步研究来证明含必需氨基酸的营养补充剂对这些患者肺功能测试的影响。
