Department of Pulmonary Medicine, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
Respirology. 2013 Nov;18(8):1217-22. doi: 10.1111/resp.12133.
Chronic obstructive pulmonary disease (COPD) is considered a worldwide major public health problem. Weight loss, muscle and fat mass depletion are common nutritional problems in COPD patients and are determinant factors in pulmonary function, health status, disability and mortality. We aimed to assess the relationships between nutritional status and perception of dyspnoea, pulmonary function tests (PFT), exercise capacity and health-related quality of life (HRQoL) using the subjective global assessment (SGA) in COPD patients who were referred for pulmonary rehabilitation programme.
A total of 163 patients with stable COPD who are candidates for outpatient pulmonary rehabilitation programme were included in this study. Nutritional status for all patients was assessed by SGA. Association of SGA scores (A, B and C) and anthropometric measurements, PFT, dyspnoea scales (Medical Research Council and resting BORG scale), HRQoL (St. George Respiratory Questionnaire and Chronic Respiratory Diseases Questionnaire) and exercise testing (shuttle walking test) were studied for statistical significance.
Based on SGA, 9.2% of patients were severely malnourished (SGA-C). There were significant decreases in forced expiratory volume in the first second (FEV1 ) (P = 0.009), Medical Research Council scales (P < 0.001) and exercise capacity (incremental shuttle walking test (P = 0.001) and endurance shuttle walking test (P = 0.009)) in SGA-C. Deterioration in anthropometric measurements and HRQoL measures were observed in malnourished patients.
Identifying the nutritional status and determining any requirement for nutritional supplement is an important component of comprehensive pulmonary rehabilitation programme. SGA is an easy and practical method to assess nutritional status in pulmonary rehabilitation candidate patients with stable COPD.
慢性阻塞性肺疾病（COPD）被认为是全球主要的公共卫生问题。体重减轻、肌肉和脂肪质量消耗是 COPD 患者常见的营养问题，也是肺功能、健康状况、残疾和死亡率的决定因素。我们旨在评估营养状况与呼吸困难感知、肺功能检查（PFT）、运动能力和健康相关生活质量（HRQoL）之间的关系，使用主观整体评估（SGA）评估因稳定期 COPD 而被转诊至肺康复计划的患者。
共纳入 163 名稳定期 COPD 患者，这些患者均为门诊肺康复计划的候选者。所有患者的营养状况均通过 SGA 进行评估。对 SGA 评分（A、B 和 C）与人体测量学测量值、PFT、呼吸困难量表（医疗研究委员会和静息 BORG 量表）、HRQoL（圣乔治呼吸问卷和慢性呼吸道疾病问卷）和运动测试（穿梭步行测试）进行相关性研究，以评估统计学意义。
根据 SGA，9.2%的患者存在严重营养不良（SGA-C）。SGA-C 患者的第一秒用力呼气量（FEV1）（P = 0.009）、医疗研究委员会量表（P < 0.001）和运动能力（递增穿梭步行测试（P = 0.001）和耐力穿梭步行测试（P = 0.009））均显著下降。营养不良患者的人体测量学和 HRQoL 指标均恶化。
确定营养状况并确定任何营养补充需求是综合肺康复计划的重要组成部分。SGA 是评估稳定期 COPD 肺康复候选患者营养状况的一种简单实用的方法。
