Gray-Donald K, Gibbons L, Shapiro S H, Martin J G
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
Am Rev Respir Dis. 1989 Dec;140(6):1544-8. doi: 10.1164/ajrccm/140.6.1544.
The purpose of our study was to examine the nutritional status of patients with severe chronic obstructive pulmonary disease (COPD) (mean predicted FEV1, 30 +/- 11%) and to explore its relationship to functional capacity. Functional capacity was evaluated by measuring peak oxygen consumption (VO2max) using an incremental cycle ergometry test, a 6-min walk test, self-perceived level of dyspnea, and quality of life. The percentage ideal body weight (%IBW) was less than 90% in 33 of 135 subjects. Triceps skinfold thickness was less than 60% of normal in 19 of 33 of these subjects. Total lymphocyte count was not different between groups, whereas hemoglobin (14.9 versus 15.9 g/dl) and albumin (4.0 versus 4.1 g/dl) were marginally reduced in underweight subjects. Dyspnea and overall quality of life were unaffected by nutritional status. Maximal inspiratory (Pimax) and expiratory mouth pressures (PEmax) were weakly associated with %IBW (R2 = 0.04; p = 01 and R2 = 0.15; p less than 0.01, respectively). The %IBW was a predictor of VO2max (percent predicted) after controlling for FEV1 in regression analysis (partial R2 = 0.08; p less than 0.001). Despite the association of weight status with VO2max, the 6-min walk was not influenced by %IBW. The perceived intensity of exercise as judged by the Borg score was far greater with the bicycle exercise that with the 6-min walk (mean score, 10.6 +/- 1.2 versus 4.6 +/- 1.9). This was supported by the difference in heart rate after these two tests.(ABSTRACT TRUNCATED AT 250 WORDS)
我们研究的目的是检查重度慢性阻塞性肺疾病（COPD）患者（预计FEV1平均值为30±11%）的营养状况，并探讨其与功能能力的关系。通过递增式运动心肺功能测试、6分钟步行测试、自我感觉呼吸困难程度和生活质量来评估功能能力。135名受试者中有33人的理想体重百分比（%IBW）低于90%。在这些受试者中的33人中有19人的三头肌皮褶厚度低于正常的60%。各组间总淋巴细胞计数无差异，而体重过轻的受试者血红蛋白（14.9对15.9 g/dl）和白蛋白（4.0对4.1 g/dl）略有降低。呼吸困难和总体生活质量不受营养状况影响。最大吸气压（Pimax）和呼气口压（PEmax）与%IBW的相关性较弱（R2 = 0.04；p = 0.1和R2 = 0.15；p < 0.01）。在回归分析中，控制FEV1后，%IBW是预测最大摄氧量（预测百分比）的指标（偏R2 = 0.08；p < 0.001）。尽管体重状况与最大摄氧量有关，但6分钟步行不受%IBW影响。根据Borg评分判断，自行车运动时的运动感知强度远高于6分钟步行（平均评分，10.6±1.2对4.6±1.9）。这得到了这两项测试后心率差异的支持。（摘要截断于250字）
