Schols A M, Soeters P B, Mostert R, Saris W H, Wouters E F
Department of Pulmonary Diseases, University of Limburg, Maastricht, The Netherlands.
Am Rev Respir Dis. 1991 Jun;143(6):1248-52. doi: 10.1164/ajrccm/143.6.1248.
A substantial number of patients with chronic obstructive pulmonary disease (COPD) suffer from gradual and significant weight loss during the natural course of their illness. The aim of this study was to determine the contribution of resting energy expenditure (REE) and energy intake (E-Intake) to weight loss in 80 patients with stable COPD: age (mean +/- SEM) 65 +/- 3 yr and FEV1 1.0 +/- 0.1 L. A total of 39 patients exhibited a continued weight loss in the previous year. REE measured with a ventilated hood system was significantly (p less than 0.005) higher in weight-losing compared to weight-stable patients when values were normalized for predicted metabolic rate (117 +/- 3 and 108 +/- 2%, respectively) or kg fat-free mass using bioelectrical impedance (FFM-BI): 35.0 +/- 0.8 and 31.8 +/- 0.6 kcal/kg, respectively). Normalized values of E-Intake were not significantly different between weight-losing and weight-stable patients. REE/FFM-BI correlated significantly with FEV1 (r = 0.22, p less than 0.05), maximal inspiratory mouth pressure (Plmax; r = 0.35, p less than 0.001), and E-Intake/FFM-BI (r = 0.48, p less than 0.001). Classification in three subgroups by severity of disease, (1) FEV1 greater than 35%, (2) FEV1 less than or equal to 35%, and (3) PaO2 less than 7.3 kPa, revealed a higher prevalence of weight loss in the more compromised groups and a significantly decreased (p less than 0.05) E-Intake in the hypoxemic patients.(ABSTRACT TRUNCATED AT 250 WORDS)
相当数量的慢性阻塞性肺疾病（COPD）患者在疾病自然进程中会逐渐出现显著体重减轻。本研究旨在确定静息能量消耗（REE）和能量摄入（E-Intake）对80例稳定期COPD患者体重减轻的影响：年龄（均值±标准误）65±3岁，第一秒用力呼气容积（FEV1）为1.0±0.1L。共有39例患者在过去一年持续体重减轻。使用通风面罩系统测量的REE，在根据预测代谢率（分别为117±3%和108±2%）或使用生物电阻抗法测定的无脂肪体重（FFM-BI）进行标准化后，体重减轻患者显著高于体重稳定患者（p<0.005）：分别为35.0±0.8和31.8±0.6千卡/千克。体重减轻和体重稳定患者的E-Intake标准化值无显著差异。REE/FFM-BI与FEV1显著相关（r=0.22，p<0.05）、最大吸气口腔压力（Plmax；r=0.35，p<0.001）以及E-Intake/FFM-BI（r=0.48，p<0.001）。根据疾病严重程度分为三个亚组：（1）FEV1大于35%，（2）FEV1小于或等于35%，（3）动脉血氧分压（PaO2）小于7.3kPa，结果显示病情越严重的组体重减轻发生率越高，低氧血症患者的E-Intake显著降低（p<0.05）。（摘要截断于250字）
