Ogan Nalan, Yıldırım Fatma, Süzen Banu, Baha Ayşe, Akpınar Evrim Eylem
Department of Pulmonary Medicine, Ufuk University School of Medicine, Ankara, Turkey.
Clinic of Pulmonary and Critical Care Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Turk Thorac J. 2020 Jan;21(1):49-53. doi: 10.5152/TurkThoracJ.2019.180194. Epub 2020 Jan 1.
Dyspnea is a prominent symptom of chronic obstructive pulmonary disease (COPD). Patients with Global Initiative for Obstructive Lung Disease (GOLD) Stage C-D often complain of dyspnea, but the relationship between their level of dyspnea and their nutritional status has not yet been established. The aim of this study was to evaluate the dyspnea levels and nutritional status ofstable COPD patients in the out patient clinic.
Medical records including the Modified Medical Research Council (mMRC) Dyspnea Scale and the nutritional status of 41 patients were investigated in the study. The meanage of patients was 71.7±9.2 years. The Nutritional Risk Screening 2002 (NRS-2002) tool, body mass index (BMI), and mid-upper arm circumference were used to evaluate their nutritional status. We used correlation analysis to display the relationship between NRS-2002 score and MRC, COPD stage, and biochemical and anthropometric parameters indicating the nutritional status of patients.
Out of the 41 COPD patients 87.8% (36) enrolled in the study were men and 12.2% (5) were women. The GOLD stages of the patients were 29.3% of patients with stage C and 70.7% with stage D. The risk of malnutrition (NRS ≥3) was detected in 48.8% of the patients, whereas 51.2% of patients (NRS<3) were risk-free. The mid-upper arm circumference of at risk patients was lower (25.6±3.2 vs 29.9±2.7 cm, p=0.032). The NRS-2002 score had a positive correlation with mMRC records (r=0.351, p=0.024). There was a statistically significant negative correlation between the NRS-2002 score and the mid-upper arm circumference (r=0.604, p<0.0001). Also, there was a negative correlation between BMI and mid-upper arm circumference (r=0.699, p<0.0001).
The risk of malnutrition was common in stable COPD patients at the outpatient clinic, which seemed to adversely affect their dyspnea level. Therefore, while planning the treatment of COPD patients, evaluating their nutritional status and taking precautions accordingly contribute to the shortness of breath which is one of the most significant symptoms of the disease.
呼吸困难是慢性阻塞性肺疾病（COPD）的一个突出症状。慢性阻塞性肺疾病全球倡议组织（GOLD）C - D期的患者常诉说有呼吸困难，但他们的呼吸困难程度与营养状况之间的关系尚未明确。本研究的目的是评估门诊稳定期COPD患者的呼吸困难程度和营养状况。
本研究调查了41例患者的病历，包括改良医学研究委员会（mMRC）呼吸困难量表和营养状况。患者的平均年龄为71.7±9.2岁。使用营养风险筛查2002（NRS - 2002）工具、体重指数（BMI）和上臂中部周长来评估他们的营养状况。我们使用相关性分析来展示NRS - 2002评分与MRC、COPD分期以及表明患者营养状况的生化和人体测量参数之间的关系。
在41例COPD患者中，87.8%（36例）为男性，12.2%（5例）为女性。患者的GOLD分期为C期占29.3%，D期占70.7%。48.8%的患者检测到存在营养不良风险（NRS≥3），而51.2%的患者（NRS<3）无风险。有风险患者的上臂中部周长较低（25.6±3.2 vs 29.9±2.7 cm，p = 0.032）。NRS - 2002评分与mMRC记录呈正相关（r = 0.351，p = 0.024）。NRS - 2002评分与上臂中部周长之间存在统计学显著负相关（r = 0.604，p<0.0001）。此外，BMI与上臂中部周长之间也存在负相关（r = 0.699，p<0.0001）。
门诊稳定期COPD患者中营养不良风险普遍存在，这似乎对他们的呼吸困难程度有不利影响。因此，在规划COPD患者的治疗时，评估他们的营养状况并相应采取预防措施有助于缓解作为该疾病最显著症状之一的呼吸急促。
