Wilson D O, Rogers R M, Wright E C, Anthonisen N R
Department of Medicine, University of Pittsburgh, Pennsylvania.
Am Rev Respir Dis. 1989 Jun;139(6):1435-8. doi: 10.1164/ajrccm/139.6.1435.
This study reviews the relationship between body weight, pulmonary function, and survival in the recent clinical trial of intermittent positive pressure breathing (IPPB). We related body weight, expressed as a percent of the ideal (%IBW), to the numerous other features of the disease recorded in this data set. Body weight was directly related to FEV1 (p = 0.0001), so that all subsequent analyses of body weight had to first consider FEV1. Mortality appeared to be influenced by body weight independent of FEV1. In patients with %FEV1 less than 35, mortality increased with decreasing body weight (p = 0.093), and this relationship was stronger in patients with %FEV1 35 to 47 (p = 0.048) and even stronger in patients with %FEV1 greater than 47 (p = 0.007). After adjusting for FEV1, body weight was a powerful positive correlate with exercise capacity (p = 0.0001). Body weight was also inversely related to %TLC (p = 0.0408) after adjusting for FEV1. Body weight was a powerful predictor of diffusing capacity (p = 0.0001) in patients with the same FEV1. These results support the hypothesis that factors related to nutritional status are an independent influence on the course of COPD.
本研究回顾了近期间歇性正压通气（IPPB）临床试验中体重、肺功能和生存率之间的关系。我们将以理想体重百分比（%IBW）表示的体重与该数据集中记录的疾病的许多其他特征相关联。体重与第一秒用力呼气容积（FEV1）直接相关（p = 0.0001），因此所有后续的体重分析都必须首先考虑FEV1。死亡率似乎受独立于FEV1的体重影响。在第一秒用力呼气容积百分比（%FEV1）小于35的患者中，死亡率随体重下降而增加（p = 0.093），在%FEV1为35至47的患者中这种关系更强（p = 0.048），在%FEV1大于47的患者中甚至更强（p = 0.007）。在对FEV1进行校正后，体重与运动能力呈强正相关（p = 0.0001）。在对FEV1进行校正后，体重与肺总量百分比（%TLC）也呈负相关（p = 0.0408）。在具有相同FEV1的患者中，体重是弥散能力的有力预测指标（p = 0.0001）。这些结果支持了这样一种假设，即与营养状况相关的因素对慢性阻塞性肺疾病（COPD）的病程具有独立影响。
