Division of Pulmonary Medicine, Buddhist Tzu-Chi General Hospital, Taipei Branch, Taipei, Taiwan.
Respirology. 2011 Feb;16(2):276-83. doi: 10.1111/j.1440-1843.2010.01895.x.
An estimated 20-40% of COPD patients are underweight. We sought to confirm the physiological and psychosocial benefits of pulmonary rehabilitation programmes (PRP) in underweight compared with non-underweight patients with COPD.
Twenty-two underweight COPD patients with BMI <20 kg/m(2), and 22 non-underweight COPD patients, who were matched for FEV(1) and age, were studied. All patients had moderate-to-very severe COPD. All patients participated in 12-week, hospital-based outpatient PRP consisting of two sessions per week. Baseline and post-PRP status were evaluated by spirometry, cardiopulmonary exercise testing, ventilatory muscle strength and the St. George's Respiratory Questionnaire (SGRQ).
At baseline, the age distribution and airflow obstruction were similar in underweight and non-underweight patients with COPD. Baseline exercise capacity, inspiratory muscle strength and SGRQ total and symptoms scores were significantly lower in the underweight patients (all P < 0.05). After the PRP, there was significant weight gain in the underweight COPD patients (mean increase 0.8 kg, P = 0.01). There were also significant improvements in peak oxygen uptake, peak workload and the SGRQ total, symptoms, activity and impact scores in both underweight and non-underweight patients with COPD (all P < 0.05).
Underweight patients with COPD have impaired exercise capacity and health-related quality of life (HRQL). Exercise training with supplemental oxygen may result in significant weight gains and improvements in exercise capacity and HRQL. Exercise training is indicated for underweight patients with COPD.
据估计，20%-40%的 COPD 患者体重过轻。我们旨在证实与非体重过轻的 COPD 患者相比，体重过轻的 COPD 患者接受肺康复计划（PRP）治疗在生理和心理方面的获益。
本研究纳入 22 例 BMI<20kg/m²的体重过轻的 COPD 患者，以及 22 例年龄、FEV1 与之匹配的非体重过轻的 COPD 患者。所有患者均患有中重度 COPD。所有患者均参加了为期 12 周的、基于医院的门诊 PRP，每周进行 2 次治疗。通过肺量测定法、心肺运动测试、呼吸肌力量和圣乔治呼吸问卷（SGRQ）评估患者 PRP 前后的状态。
在基线时，体重过轻和非体重过轻的 COPD 患者的年龄分布和气流阻塞情况相似。基线时，体重过轻的 COPD 患者的运动能力、吸气肌力量和 SGRQ 总分及症状评分均显著更低（所有 P<0.05）。在 PRP 之后，体重过轻的 COPD 患者的体重显著增加（平均增加 0.8kg，P=0.01）。体重过轻和非体重过轻的 COPD 患者的峰值摄氧量、峰值工作量以及 SGRQ 总分、症状、活动和影响评分均有显著改善（所有 P<0.05）。
体重过轻的 COPD 患者的运动能力和健康相关生活质量（HRQL）受损。补充氧的运动训练可能导致体重显著增加，并改善运动能力和 HRQL。运动训练适用于体重过轻的 COPD 患者。
