Horácek J, Král B, Bures J, Pidrman V
2. interní klinika FN a LF UK, Hradec Králové.
Vnitr Lek. 1995 Jul;41(7):493-7.
Malnutrition occurs in 23-70% of patients with chronic obstructive pulmonary disease and appears to be an independent factor connected with poor prognosis. Malnutrition stems from a long-term negative balance of energy and nutrients. That is caused by hypermetabolism, with possible role of an increased thermic effect of food, and probably by (at least intermittently) a limited intake of food. The adverse effect of malnutrition may be mediated by a decreased respiratory muscle strength but also by other mechanisms (electrolyte disorders, disturbed respiratory control, immunosuppression). In these patients, realimentation may be difficult to achieve, especially on the out-patient basis. However, with an increased effort of the health professionals and a good compliance of the patients, a substantial improvement is feasible, which might in turn improve the patients' prognosis.
23%至70%的慢性阻塞性肺疾病患者存在营养不良，且营养不良似乎是与预后不良相关的独立因素。营养不良源于能量和营养物质的长期负平衡。这是由高代谢引起的，食物的热效应增加可能起到了作用，并且可能（至少是间歇性地）由于食物摄入量有限。营养不良的不良影响可能通过呼吸肌力量减弱介导，但也可能通过其他机制（电解质紊乱、呼吸控制障碍、免疫抑制）。在这些患者中，尤其是在门诊情况下，可能难以实现营养补充。然而，随着医护人员的更多努力以及患者的良好依从性，显著改善是可行的，这反过来可能会改善患者的预后。
