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慢性阻塞性肺疾病(COPD)门诊患者的营养状况、饮食摄入量及健康相关生活质量

Nutritional status, dietary intake, and health-related quality of life in outpatients with COPD.

作者信息

Nguyen Ha Thanh, Collins Peter F, Pavey Toby G, Nguyen Nhung Viet, Pham Tuong Duy, Gallegos Danielle L

机构信息

School of Exercise and Nutrition Sciences, Faculty of Health Queensland University of Technology, Kelvin Grove, QLD, Australia,

Department of Nutrition and Food Safety, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam,

出版信息

Int J Chron Obstruct Pulmon Dis. 2019 Jan 14;14:215-226. doi: 10.2147/COPD.S181322. eCollection 2019.

Abstract

BACKGROUND

Malnutrition is common in patients with COPD; however, little is known about its impacts on health-related quality of life (QoL) among patients with COPD. This study aimed to explore the nutritional status and dietary intake among outpatients with COPD in Vietnam and its possible associations with QoL.

METHODS

A cross-sectional study was carried out in COPD outpatients visiting the COPD management unit at the National Lung Hospital, Hanoi, Vietnam between May 2017 and July 2017. Consecutive outpatients with a confirmed diagnosis of COPD were recruited with written inform consent. The nutritional status of participants was assessed using Subjective Global Assessment (SGA), and dietary intake via a 24-hour recall interview. The St George Respiratory Questionnaire (SGRQ) for COPD was used to investigate the participants' QoL. Sociodemographic and clinical data were extracted from hospital records.

RESULTS

Of 168 COPD outpatients involved in the study, three-quarters (74.4%) were diagnosed as malnourished (SGA B/C) and 81.5% reported unintentional weight loss. Most of the patients did not meet their estimated energy and protein requirements (85.7% and 89.9%, respectively). Malnutrition was significantly associated with disease severity (=0.039) and ratio of protein intake to estimated requirement (=0.005). QoL was low for all levels of malnutrition or disease severity, with well-nourished participants and those with less disease severity having better QoL (=0.006 and <0.001, respectively). With an extra meal per day, the odds of having malnutrition decreased 5.6 times (<0.05) and the total SGRQ reduced 3.61 scores (<0.05) indicating a better QoL.

CONCLUSION

Malnutrition and weight loss are prevalent among COPD outpatients. Most of the patients had inadequate dietary intake and low QoL. Nutrition counselling including increasing the number of meals per day with a focus on energy- and protein-rich foods may help improving nutritional status and QoL of patients with COPD in Vietnam.

摘要

背景

慢性阻塞性肺疾病(COPD)患者中营养不良很常见;然而,关于其对COPD患者健康相关生活质量(QoL)的影响知之甚少。本研究旨在探讨越南COPD门诊患者的营养状况和饮食摄入情况及其与生活质量的可能关联。

方法

2017年5月至2017年7月期间,在越南河内国家肺病医院COPD管理单元就诊的COPD门诊患者中进行了一项横断面研究。连续纳入确诊为COPD的门诊患者,并获得书面知情同意。使用主观全面评定法(SGA)评估参与者的营养状况,并通过24小时回顾性访谈评估饮食摄入情况。使用慢性阻塞性肺疾病圣乔治呼吸问卷(SGRQ)调查参与者的生活质量。从医院记录中提取社会人口统计学和临床数据。

结果

在参与研究的168例COPD门诊患者中,四分之三(74.4%)被诊断为营养不良(SGA B/C级),81.5%的患者报告有非故意体重减轻。大多数患者未达到其估计的能量和蛋白质需求(分别为85.7%和89.9%)。营养不良与疾病严重程度(P = 0.039)和蛋白质摄入量与估计需求量的比值(P = 0.005)显著相关。无论营养不良程度或疾病严重程度如何,生活质量均较低,营养良好的参与者和疾病严重程度较低的参与者生活质量较好(分别为P = 0.006和P < 0.001)。每天多吃一顿饭,发生营养不良的几率降低5.6倍(P < 0.05),SGRQ总分降低3.61分(P < 0.05),表明生活质量更好。

结论

营养不良和体重减轻在COPD门诊患者中普遍存在。大多数患者饮食摄入不足且生活质量较低。营养咨询,包括增加每日餐数,重点是富含能量和蛋白质的食物,可能有助于改善越南COPD患者的营养状况和生活质量。

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