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蛋白质补充对慢性阻塞性肺疾病患者生活质量、身体功能和肌肉力量的影响。

The effect of protein supplementation on quality of life, physical function, and muscle strength in patients with chronic obstructive pulmonary disease.

作者信息

Ahnfeldt-Mollerup P, Hey H, Johansen C, Kristensen S, Brix Lindskov J, Jensahnfeldt-Mollerupen C

机构信息

Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark -

出版信息

Eur J Phys Rehabil Med. 2015 Aug;51(4):447-56. Epub 2014 Nov 26.

PMID:25426541
Abstract

BACKGROUND

The combination of protein supplementation with exercise is successful in increasing weight and energy intake, as well as exercise capacity and health-related quality of life in sarcopenic patients diagnosed with chronic obstructive disease (COPD). However, the potential benefit of protein supplementation for non-sarcopenic patients with COPD has yet not previously been examined.

AIM

The aim of this trial was to evaluate the effect of protein supplementation on quality of life, physical function, muscle strength and biochemical blood markers in patients diagnosed with COPD undergoing nine weeks of pulmonary rehabilitation.

DESIGN

A prospective, parallel group randomised clinical trial.

SETTING

Patients referred from their general practitioners to the COPD rehabilitation outpatient programme at the local community rehabilitation centre.

POPULATION

Patients (N.=53) with stable moderate to severe COPD diagnosed with COPD, 40 years or older and with a BMI<30.

METHODS

The participants were assigned to one of two groups to receive either twice daily protein supplementation (9.3 g of protein/566.4 KJ) plus exercise or exercise only. Before and after nine weeks of rehabilitation, mental state was measured by means of St George Respiratory Questionnaire, physical performance was evaluated by shuttle walking test and maximal muscle strength test, and fasting blood samples were analyzed.

RESULTS

Supplementing exercise with protein had no additional effect on any of the outcome measures. However, shuttle walk time, St George total score and subscore for impact improved as effect of time.

CONCLUSION

This trial was unable to provide evidence for the effect of protein supplementation on quality of life, physical function, and muscle strength in non-sarcopenic patients with moderate to severe COPD.

CLINICAL REHABILITATION IMPACT

The role of protein supplementation in COPD-rehabilitation should focus on identifying patients to receive supplement with protein and from those who will not benefit.

摘要

背景

蛋白质补充与运动相结合,成功增加了被诊断患有慢性阻塞性肺疾病(COPD)的肌少症患者的体重、能量摄入、运动能力以及与健康相关的生活质量。然而,蛋白质补充对非肌少症COPD患者的潜在益处此前尚未得到研究。

目的

本试验旨在评估蛋白质补充对接受为期九周肺康复治疗的COPD患者的生活质量、身体功能、肌肉力量和血液生化指标的影响。

设计

一项前瞻性、平行组随机临床试验。

地点

从全科医生处转诊至当地社区康复中心COPD康复门诊项目的患者。

研究对象

53例年龄40岁及以上、BMI<30且被诊断为稳定期中度至重度COPD的患者。

方法

参与者被分为两组,一组每天接受两次蛋白质补充(9.3克蛋白质/566.4千焦)加运动,另一组仅接受运动。在康复九周前后,通过圣乔治呼吸问卷测量心理状态,通过往返步行试验和最大肌肉力量测试评估身体表现,并分析空腹血样。

结果

蛋白质补充联合运动对任何一项结局指标均无额外影响。然而,往返步行时间、圣乔治总分及影响子分数随时间推移有所改善。

结论

本试验无法为蛋白质补充对中度至重度非肌少症COPD患者的生活质量、身体功能和肌肉力量的影响提供证据。

临床康复意义

蛋白质补充在COPD康复中的作用应侧重于确定哪些患者能从蛋白质补充中获益,哪些患者不能。

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