Kuo C D, Shiao G M, Lee J D
Respiratory Therapy Department, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Chest. 1993 Jul;104(1):189-96. doi: 10.1378/chest.104.1.189.
Reducing the CO2 production (VCO2) is a plausible means to lower the ventilatory demand in the treatment of patients with COPD. The purpose of this study was to examine the effects of high-fat and high-carbohydrate (high-CHO) diet loads on gas exchange and ventilation in the COPD patients and normal subjects. The percentage of changes in the averaged values of VCO2, O2 consumption (VO2), respiratory quotient (RQ), minute ventilation (VE), and end-tidal CO2 (ETCO2) measured by a mass spectrometer for 5 min every 30 min after the diet were compared between diets and between study subjects. Compared with the high-fat diet, the high-CHO diet can lead to significantly higher levels of VCO2, VO2, RQ, and VE in the COPD patients 30 to 60 min after the diet, and the differences can last for about 1.5 h. The comparison between COPD patients and normal control subjects also showed that the high-CHO diet load can result in significantly higher levels of VCO2, VO2, and VE, and significantly lower level of ETCO2 in the COPD patients, whereas the high-fat diet cannot. In addition, enhanced thermic effect of food within 150 min (TEF150) occurred in the COPD patients as compared with that of normal controls, and the increase in TEF150 occurred only with the high-CHO diet. This study suggested that a high-fat diet is more beneficial to the COPD patient than a high-CHO diet, and that the gas exchange and energy utilization of the COPD patients following a high-CHO diet might be different from that of normal control subjects.
降低二氧化碳产生量(VCO2)是降低慢性阻塞性肺疾病(COPD)患者通气需求的一种可行方法。本研究旨在探讨高脂和高碳水化合物(高CHO)饮食负荷对COPD患者和正常受试者气体交换及通气的影响。比较不同饮食以及不同研究对象在饮食后每隔30分钟用质谱仪测量5分钟所得的VCO2、氧气消耗量(VO2)、呼吸商(RQ)、分钟通气量(VE)和呼气末二氧化碳(ETCO2)平均值的变化百分比。与高脂饮食相比,高CHO饮食可使COPD患者在饮食后30至60分钟时的VCO2、VO2、RQ和VE水平显著升高,且差异可持续约1.5小时。COPD患者与正常对照受试者之间的比较还显示,高CHO饮食负荷可使COPD患者的VCO2、VO2和VE水平显著升高,ETCO2水平显著降低,而高脂饮食则不会。此外,与正常对照相比,COPD患者在150分钟内食物的热效应增强(TEF150),且仅在高CHO饮食时TEF150增加。本研究表明,高脂饮食对COPD患者比高CHO饮食更有益,且高CHO饮食后COPD患者的气体交换和能量利用可能与正常对照受试者不同。