中老年人群体质指数分布及理想值的探讨

以上海市３５岁以上城市居民１５８２７例为研究对象,对中老年人群体质指数的分布及理想进行了探讨。结果显示,不同性别、年龄的死亡率曲线均可拟合Ｙ＝ａ－ｂＸ＋ｃＸ＾２的二次曲线分布。将曲线最低点所对应的ＢＭＩ值作为相应队列人群的理想值,并根据公式－ｂ／２ｃ进行计算。     

老年男性心血管危险因素聚集适宜指标和切点

目的 探讨老年男性心血管危险因素聚集的适宜体质量指数(BMI)、体脂百分比(PBF)和体脂指数(BFMI)切点。 方法 收集2007年1 052例上海市老年男性健康体检资料,分析不同BMI、PBF和BFMI水平与心血管危险因素聚集的关系;采用受试者工作特征(ROC)曲线分析BMI、PBF和BFMI最适切点;通过曲线下面积（AUC）分析BMI、PBF和BFMI的诊断价值;计算各切点检出危险因素聚集的人群归因危险度百分比(PARP)。 结果 随BMI、PBF和BFMI增加,危险因素聚集的比值比(OR)呈升高趋势。ROC曲线分析显示,BMI≥24 kg/m2、PBF≥21%和BFMI≥5 kg/m2为敏感性和特异性较均衡、和（或）ROC曲线距离最短的切点;三项指标AUC均＞0.5。PARP分析显示,BMI、PBF和BFMI分别控制于24 kg/m2、21%和5 kg/m2以下,能分别防止人群中27.1%、37.44%和36.63%的危险因素聚集。 结论 反映老年男性心血管危险因素聚集的适宜BMI、PBF和BFMI切点分别为24 kg/m2、21%和5 kg/m2。     

老年男性心血管危险因素聚集适宜指标和切点

目的 探讨老年男性心血管危险因素聚集的适宜体质量指数(BMI)、体脂百分比(PBF)和体脂指数(BFMI)切点.方法 收集2007年1 052例上海市老年男性健康体检资料,分析不同BMI、PBF和BFMI水平与心血管危险因素聚集的关系;采用受试者工作特征(ROC)曲线分析BMI、PBF和BFMI最适切点;通过曲线下面积(AUC)分析BMI、PBF和BFMI的诊断价值;计算各切点检出危险因素聚集的人群归因危险度百分比(PARP).结果 随BMI、PBF和BFMI增加,危险因素聚集的比值比(OR)呈升高趋势.ROC曲线分析显示,BMI≥24 kg/m2、PBF≥21%和BFMI≥5 kg/m2为敏感性和特异性较均衡、和(或)ROC曲线距离最短的切点;三项指标AUC均＞0.5.PARP分析显示,BMI、PBF和BFMI分别控制于24 kg/m2、21%和5 kg/m2以下,能分别防止人群中27.1%、37.44%和36.63%的危险因素聚集.结论 反映老年男性心血管危险因素聚集的适宜BMI、PBF和BFMI切点分别为24 kg/m2、21%和5 kg/m2.     

475例机关退休干部心血管疾病体检结果分析

目的 调查机关退休干部心血管疾病发病情况以及与体质指数的关系,为健康指导和疾病防治提供依据.方法 对475例退休干部的血压、血脂、血糖与体质指数等因素进行测定,分析它们之间的联系.结果 随着体质指数的增加,舒张压、收缩压、空腹血糖、总胆固醇水平上升,高密度脂蛋白胆固醇水平下降.高血压、糖尿病、血脂异常的发病率随着体质指...     

Distribution and desirable value of body mass index in middle and oldaged Shanghai urban residents

ＤｉｓｔｒｉｂｕｔｉｏｎａｎｄｄｅｓｉｒａｂｌｅｖａｌｕｅｏｆｂｏｄｙｍａｓｓｉｎｄｅｘｉｎｍｉｄｄｌｅａｎｄｏｌｄａｇｅｄＳｈａｎｇｈａｉｕｒｂａｎｒｅｓｉｄｅｎｔｓＧｕｏＱｉａｎｇ（郭强）;ＸｕｅＧｕａｎｇｂｏ（薛广波）;ＺｈｅｎｇＨｕｉｍｉｎ（...     

Association between body mass index and pulmonary function of patients with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease （COPD） is a major cause of chronic morbidity and mortality throughout the world. It is a preventable and treatable disease with significant extra pulmonary effects that may contribute to the severity in individual patients. It is characterized by airflow limitation that is not fully reversible. The diagnosis of COPD should be confirmed by spirometry. Body mass index （BMI） is an important indicator that can well reflect nutritional status of patients, and low BMI is an independent risk factor for mortality in patients with COPD.     

不同BMI的2型糖尿病患者心血管等靶器官功能损伤的风险评估

目的 探讨不同体质量指数(BMI)的2型糖尿病患者心血管等靶器官功能损伤的风险.方法 自2014年1月至2016年1月前瞻性收集该院收治的2型糖尿病患者126例,其中研究组(BMI≥25 kg/m2)57例,对照组(18.5 kg/m2≤BMI＜25kg/m2)69例.分析两组患者的临床特征,并分析BMI与靶器官损伤相关指标[颈动脉内膜中膜厚度(IMT)、动脉硬化指数、冠心病指数和肾小球滤过率]的相关性.结果 两组患者空腹血糖差异无统计学意义(P=0.953),研究组患者BMI显著高于对照组(P=0.000).与对照组比较,研究组患者年龄显著增加(P=0.038);收缩压显著增加(P=0.000);糖尿病家族史显著增加(P=0.000);总胆固醇显著增加(P=0.012);三酰甘油显著增加(P=0.000);高密度脂蛋白显著降低(P=0.003);HOMA-IR水平显著升高(P=0.000);HOMA-β水平显著降低(P=0.000);IMT水平显著升高(P=0.000);动脉硬化指数显著升高(P=0.000);冠心病指数显著升高(P=0.001);肾小球滤过率显著降低(P=0.000).Pearson直线相关分析显示BMI与IMT、动脉硬化指数、冠心病指数和肾小球滤过率相关,r值分别为0.234、0.257、0.294和0.211(均P=0.000).结论 2型糖尿病患者BMI水平与心血管和肾功能损伤有关.     

Correlation between low tube voltage in dual source CT coronary artery imaging with image quality and radiation dose

The influence of low tube voltage in dual source CT（DSCT） coronary artery imaging on image quality and radiation dose and its application value in clinical practice were investigated. Totally, 300 cases of chest pain with low body mass index（BMI 〈18.5 kg/m2） subjected to DSCT coronary artery imaging were prospectively enrolled. The heart rate in all patients were greater than 65/min. The retrospective ECG gated scanning mode and simple random sampling method were used to assign the patients into groups A, B and C（n=100 each）. The patients in groups A, B and C experienced 120-, 100-, and 80-kV tube voltage imaging respectively, and the image quality was evaluated. The CT volume dose index（CTDIvol） and dose length product（DLP） were recorded, and the effective dose（ED） was calculated in each group. The image quality scores and radiation doses in groups were compared, and the influence of tube voltage on image quality and radiation dose was analyzed. The results showed that the excellent rate of image quality in groups A, B and C was 95.69%, 94.72% and 96.33% respectively with the difference being not statistically significant among the three groups（P〉0.05）. The CTDIvol values in groups A, B and C were 51.35±12.21, 21.28±7.13 and 6.34±3.34 mGy, respectively, with the difference being statistically significant（P〈0.05）. The ED values in groups A, B and C were 9.27±1.63, 4.56±2.29 and 2.29±1.69 mSv, respectively, with the difference being statistically significant（P〈0.05）. It was suggested that for the patients with low BMI, the application of DSCT coronary artery imaging with low tube voltage can obtain satisfactory image quality, and simultaneously, significantly reduce the radiation dose.     

Breast milk macronutrient composition and the associated factors in urban Chinese mothers

Background Infancy is a critical period of growth and physiological development,in which breast milk is the best source of nutrients.Compared to western countries,research on breast milk of Chinese population are limited.Thus,it is necessary to measure breast milk energy and macronutrient concentrations of healthy urban Chinese mothers at different lactation stages,to expand the database of milk composition of Chinese population,and to examine whether dietary or other maternal factors can affect the levels of macronutrients in breast milk.Methods Breast milk of full expression of one side breast from 436 urban Chinese lactating mothers at 5-11 days,12-30 days,31-60 days,61-120 days,and 121-240 days postpartum was obtained at 9：00 a.m.to 11：00 a.m.Total energy,lactose,protein,and fat contents were measured.24-hour dietary recall was surveyed,and maternal nutrient intakes were analyzed.Results Milk composition changed over the course of lactation and large individual variations were documented.The concentrations were 61.3 kcal/dl for total energy,7.1 g/dl for lactose,0.9 g/dl for protein,and 3.4 g/dl for fat in mature milk.Stage of lactation was a strong factor affecting milk composition.Minimal evidence was found for associations between maternal current dietary intake and milk macronutrient concentration,consistently with prior research.Maternal body mass index （BMI） was positively associated with milk fat content,to a greater extent than did dietary intake.All other maternal characteristics were not significant for milk composition.Conclusion These findings suggest that milk composition is generally weakly associated with maternal factors except for stage of lactation,and is likely to be more susceptible to long-term maternal nutritional status than short-term dietary fluctuation.     

持续性非卧床腹膜透析患者的临床特征及影响腹膜转运功能的相关因素

目的：观察不同腹膜转运类型的持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患 者的临床特征,探讨影响腹膜转运功能的相关因素。方法：回顾性总结158例CAPD患者的临床资料,根据腹膜平衡 试验评价患者的腹膜转运功能并将其分为高平均转运+高转运组(A组,n=84)和低平均转运+低转运组(B组,n=74), 并对两组患者的人口学资料、临床生物化学指标以及心血管并发症情况进行比较;应用logistic回归分析寻找影响患 者腹膜转运功能的相关因素。结果：B组患者血清白蛋白(albumin,ALB)水平显著高于A组(P<0.05)。A组患者的4 h透 析液肌酐与血肌酐浓度的比值(dialysate/plasma creatinine,D/Pcr)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs- CRP)、体重指数(body mass index,BMI)及心血管并发症的发生率均显著高于B组(均P<0.05)。相关分析显示：D/Pcr与 BMI,hs-CRP和心血管并发症呈正相关(分别r=0.179,0.373和0.426,均P<0.05);与ALB呈负相关(r=–0.393,P<0.01)。 Logistic回归分析显示：高BMI(OR=1.178,P<0.05)、心血管并发症(OR=5.035,P<0.01)以及低血清ALB(OR=0.852, P<0.01)为患者腹膜高转运的危险因素。结论：腹膜透析患者血清ALB水平、BMI和心血管并发症与腹膜高转运相关, 可作为预估患者腹膜转运功能的参考指标。     

孕前体重指数对初次妊娠妇女妊娠结局的影响

目的：探讨初次妊娠妇女待孕前体重指数对妊娠结局的影响。方法：采用回顾性群组研究方法，对2000—2006年间，在牡丹江中医院产前门诊就诊并在其院部分娩单胎的839名初次妊娠的育龄妇女进行了研究。这些妇女按体重指数分成五组：偏轻组（BMI〈18．5kg／m^2）、正常组（BMI=18．5—23．9kg/m^2）、超重组（BMI=24～27．9kg／m^2）、肥胖组（BMI=28～31．9kg／m^2）、和病态肥胖组（BMI≥32kg／m^2）。使用单变量和多变量分析对比各组对妊娠结局的影响。结果：和正常组妇女相比，病态肥胖组妇女患妊娠高血压疾病{0114．37（95％CI1．32，14．41）}和妊娠期糖尿病{OR6．01（95％CI1．95，18．52）}的风险极高，而体重偏轻组妇女的患病风险最低。病态肥胖组妇女引产几率最高{OR2．94（95％CI1．02，8．48）}，体重偏轻组妇女引产几率最低。病态肥胖组妇女剖腹产几率最高{OR3．22（95％CI1．13，9．22）}，体重偏轻组妇女剖腹产几率最低。病态肥胖组妇女更容易患产后出血症{OR4．05（95％CI1．08，15．20）}和早产{OR5．55（95％CI1．14，27．15）}。病态肥胖组妇女分娩巨大儿的风险最高{OR5．55（95％CI1．14，27．15）}，而体重偏轻组妇女风险最低。体重偏轻组妇女分娩低体重儿的风险最高{OR5．14（95％CI1．26，20．92）}。结论：孕妇体重指数的增加相应带来妊娠期高血压疾病、妊娠期糖尿病、巨起儿、引产、剖腹产发生率的增加。与拥有正常体重指数的妇女相比，体重偏轻的妇女有比较好的妊娠结局。     

体质量指数对移植肾功能的影响

目的 研究体质量指数（body mass index,BMI）对肾移植术后移植肾功能的影响。方法 回顾2008年1月-2011年12月本院肾移植受者238例临床资料,根据术前BMI分为3组：BMI〈24.9 kg/m^2（正常组,A组）,BMI 25～29.9 kg/m2（超重组,B组）,BMI≥30 kg/m2（肥胖组,C组）。对比3组术后移植肾功能延迟恢复（delayed graft function,DGF）的发生率、术后1年内急性排斥反应（acute rejection,AR）发生率、血肌酐恢复至正常水平所需时间。结果 肾移植术后DGF发生率A组为20.93%,B组为21.74%,C组为55%（P〈0.01）。急性排斥发生率A组为12.79%,B组为16.30%,C组为43.33%（P=0.088）。血肌酐恢复至正常水平所需时间A组为（7.65±3.23）d,B组为（6.99±5.36）d,C组为（11.45±6.20）d（P〈0.01）。结论 体型肥胖肾移植受者术后DGF的发生率较高,术后血肌酐恢复至正常水平所需时间更长。     

Effects of pre-pregnancy body mass index on pregnancy outcomes

Prevalence of overweight and obesity has continued to increase among women of child bearing age all over the world in recent decades. Its impact on short-term and long-term maternal and fetal outcomes continued to grow, such as increased risk of gestational diabetes mellitus, gestational hypertension, preeclampsia, fetal macrosomia, perinatal mortality and chance for cesarean deliveries） What＇s more, underweight before pregnancy also has some hazardous effects on pregnant women and fetus, such as increased risk of delivering infants small for gestational age and preterm delivery.2 The present study determined the prevalence of each body mass index （BMI） group of an obstetric population of the mainland of China, and effects of the maternal pre-pregnancy BMI on multiple antepartum, intrapartum and neonatal outcomes.     

Evaluation of a group family-based intervention programme for adolescent obesity: the LITE randomised controlled pilot trial

INTRODUCTIONThis study aimed to evaluate the LITE (Lifestyle Intervention for TEenagers) group programme, a family-based behavioural lifestyle intervention for overweight and obese adolescents.METHODSWe conducted a two-arm randomised controlled trial that recruited overweight and obese adolescents who attended a tertiary care weight management clinic. Participants were randomised to the LITE programme or usual care. The primary outcome assessed was body mass index (BMI) z-score. Secondary outcomes of anthropometric measurements, metabolic profile, parenting and adolescents’ perception of family support were measured at baseline, three months and six months. Feasibility and acceptability of the LITE programme were also evaluated.RESULTS61 adolescents were enrolled, with 31 in the LITE programme and 30 in usual care. At three months, participants in the programme had a greater reduction in weight (−0.18 ± 2.40 kg vs. 1.48 ± 1.97 kg; p = 0.107), waist circumference (−1.0 ± 3.1 cm vs. 2.4 ± 2.7 cm; p = 0.016), waist-height ratio (−0.01 ± 0.02 vs. 0.01 ± 0.02; p = 0.040) and systolic blood pressure (−3.8 ± 13.7 vs. 5.7 ± 13.1; p = 0.119) compared to the usual care group. There was no significant difference in BMI z-score. At six months, there were significant improvements in adolescents’ perception of family support for eating habits in the LITE group compared to the usual care group. The LITE programme had a good attendance rate of 67.7% and was well received.CONCLUSIONThe LITE programme showed feasibility and short-term clinical effectiveness in improving some clinical outcomes and improved adolescents’ perception of family support.     

Early Infantile Growth and Cardiovascular Risks in Adolescent Japanese Women

Objective: Early life events connected with the risk of later disease can occur not only in utero, but also in infancy. In study of the developmental origins of health and disease, the relationship between infantile growth patterns and adolescent body mass index and blood pressure is one of the most important issues to verify.Materials and Methods: We analyzed the correlation of current body mass index and systolic blood pressure of 168 female college students with their growth patterns in utero and in infancy.Results: Body mass index and systolic blood pressure in adolescence showed positive correlations with changes in weight-for-age z scores between 1 and 18 months but not with those between 18 and 36 months. Stepwise multiple regression analysis showed that both change in weight-for-age z scores from 1 to 18 months and body mass index at 1 month were significantly and independently associated with systolic blood pressure in adolescence. Body mass index at 36 months was positively correlated with body mass index in adolescence, while body mass index at birth was negatively correlated with body mass index in adolescence.Conclusion: Our findings shows that restricted growth in utero and accelerated weight gain in early infancy are associated with the cardiovascular risk factors of high systolic blood pressure and high body mass index in adolescence. In Japan, an increasing proportion of low birth weight infants and accelerated catch-up growth after birth have been observed in recent decades. This might be an alarming harbinger of an increase in diseases related to the developmental origins of health and disease in Japan.     

理想体重指数和体质指数评价住院患者营养状况的比较

目的观察理想体重指数和体质指数评价营养状况的差异性和相关性,以便更好地进行营养评价。方法选择符合条件的住院患者,男性162例和女性150例,以两种方法评价营养状况,评价标准都采用中国的标准。结果住院患者营养不良发病率接近50%,两种方法营养正常的检出率无统计学差异（P〉0.05）,理想体重指数对营养不足和肥胖的检出率相对较高,而对超重的检出率相对较低（P〈0.05）。营养过剩检出率,BMI法较高（P〈0.05）。性别对两种评价方法都无统计学差异。结论两种评价方法效果存在较明显的统计学差异,不可单独用一项指标断定营养状况,两者可以结合使用以减少评价误差,最好结合多种评价方法使用,尤其是男性。     

成年人体重指数、去脂体重指数、脂肪体重指数与深吸气量的关系

目的 研究肺功能正常成年人体重指数(BMI)、去脂体重指数(FFMI)和脂肪体重指数(FMI)与深吸气量(IC)的关系.方法 以2008年7至10月在黑龙江省进行的人体生理常数调查人群资料为基础,选取通过基础体检(不限制BMI)且肺功能正常的19～81岁成年被调查者2050人,其中男性921人,女性1129人,按照中国肥胖问题工作组推荐的中国成年人体重分类标准将检测对象分组,采用Pearson相关分析、单因素方差分析和多元逐步回归分析等统计方法分析BMI、FFMI、FMI和IC的关系.结果 控制性别、年龄、身高等混杂因素后,IC与BMI、FFMI、FMI均呈显著正相关(r=0.320,r=0.303,r=0.204,P均=0.000);IC、FFMI和FMI值,肥胖组>超重组>正常体重组>低体重组,各组间差异有统计学意义(P均=0.000).年龄、性别、身高、FFMI和FMI均是影响深吸气量IC的因素,其中身高、FFMI和FMI与IC呈正相关,性别(男=1,女=2)、年龄与IC呈负相关;影响程度由大到小依次为身高、FFMI、性别、FMI、年龄,其中FFMI对IC的影响约是FMI的2.23倍.结论 在肺功能正常的成年人中,BMI与IC呈独立正相关;FFMI和FMI是影响IC的独立因素,均与IC呈正相关;FFMI对IC的影响大于FMI.BMI对IC的提升作用与FMI和FFMI有关,其中FFMI的作用大于FMI.     

肥胖程度对急性ST段抬高型心肌梗死患者预后的影响

目的 探讨肥胖程度对于急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction, STEMI)患者预后的影响。方法 连续入选2013-2018年因首次发作STEMI收入首都医科大学宣武医院治疗的患者,按照体质量指数(body mass index, BMI)(kg/m²)将患者分为4组:低体质量组(A组):BMI<18.5 kg/m²;正常体质量组(B组):18.5 kg/m²≤BMI<24 kg/m²;超重组(C组):24.0 kg/m²≤BMI<28.0 kg/m²;肥胖组(D组):BMI≥28.0 kg/m²。比较4组患者住院和随访期间的全因死亡和主要不良心脑血管事件(major adverse cardiovascular and cerebrovascular events,MACCE)发生率。结果 低体质量组和其他3组相比男性患者所占比例更高,年龄更大。患者住院接受再灌注治疗的比例随BMI的增加整体呈现上升趋势。住院期间低体质量、正常体质量、超重和肥胖组的住院全因病死率分别为14.71%、3.97%、2.89%和3.09%,差异有统计学意义(P=0.003),低体质量组的全因病死率显著高于超重组和肥胖组。Kaplan-Meier生存曲线显示,低体质量、正常体质量、超重和肥胖组患者的5年预期全因病死率分别为37.0%、19.5%、13.8%、13.0%,差异有统计学意义(P=0.040),低体质量组的5年预期全因病死率显著高于其他3组。用限制性立方样条(restricted cubic spline,RCS)拟合Cox回归模型显示,BMI与随访全因死亡和发生MACCE的风险之间均呈U型关系。在用Cox回归分析校正了混杂因素后,BMI不是STEMI患者远期死亡或MACCE的独立预测因素。结论 肥胖程度对STEMI患者的远期预后没有直接影响。     

佛山市老年人体重指数与糖尿病的关系

目的 探讨老年人体重指数与糖尿病的关系。方法 按统一方法对佛山市60岁以上常住居民3382人进行现场问卷调查,同时测量血压、身高、体重(体质量)等,并计算体重指数(BMI)。结果 肥胖、超重、体重正常、体重过低者糖尿病患病率分别为31.58%、22.84%、15.65%和9.40%;高血糖患病率分别为67.94%、56.14%、46.58%和38.35%;随BMI增高,糖尿病、高血糖患病率明显增高。糖尿病组BMI均值为23.9kg/m²,≥24者占48.7%;高血糖组BMI均值为23.4kg/m²,≥24者占42.9%;血糖正常组BMI均值为22.6kg/m²,≥24者占32.3%,两两比较有显著性差异(P<0.01)。结论 BMI水平与糖尿病密切相关。     

体质量指数和胸部CT特征在综合评估慢性阻塞性肺疾病中的价值

目的 依据营养状况和胸部CT影像表现,分析慢性阻塞性肺疾病(COPD)患者的临床特征,探讨其在综合评估COPD中的应用价值。方法 纳入2017年6月至2018年6月在北京协和医院和民航总医院呼吸科就诊的256例COPD稳定期患者,收集人口学资料、身高、体质量、吸烟史、急性加重次数,完善肺功能检查及COPD评估测试(CAT)问卷,分析Goddard评分与肺功能、CAT评分、急性加重次数间的关系,并探索不同体质量指数(BMI)分级和各CT表现型COPD患者的临床特征。结果 体质量正常(t=-2.701,P=0.0080)、超重(t=-3.506,P=0.001)和肥胖组(t=-4.323,P=0.000)的第1秒用力呼气容积占预计值百分比(FEV₁%pred)明显高于体质量过低组,肥胖组明显高于体质量正常组(t=-3.096,P=0.002)。体质量正常(t=-3.081,P=0.002)和超重组(t=-2.766,P=0.006)的用力肺活量占预计值的百分比(FVC%pred)明显高于体质量过低组。超重组的第1秒用力呼气容积(FEV₁)/用力肺活量(FVC)明显高于体质量正常组(t=-3.702,P=0.001),肥胖组明显高于体质量过低组(t =-4.742,P=0.000)、体质量正常组(t=-5.785,P=0.000)和超重组(t=-2.984,P=0.003)。超重组的一氧化碳弥散量占预计值的百分比(DLco%pred)明显高于体质量过低组(t=-3.042,P=0.003)和体质量正常组(t=-3.128,P=0.002),肥胖组也明显高于体质量过低组(t=-4.742,P=0.000)和体质量正常组(t=-5.785,P=0.000)。超重(Z=4.535,P=0.000)和肥胖组(Z=5.422,P=0.000)的Goddard评分明显低于体质量正常组。偏相关分析结果显示,Goddard 评分与FEV₁/FVC(r=-0.230,P=0.022)和DLco%pred(r=-0.531,P=0.000)呈显著负相关,与CAT评分(r =0.244,P=0.021)呈显著正相关。E型(t=3.467,P=0.001)和M型(t=3.031,P=0.003)的BMI、E型(t=2.484,P=0.015)和M型(t=2.969,P=0.004)的FEV₁/FVC及E型(t=4.928,P=0.000)和M型(t=2.489,P= 0.0163)的DLco%pred均明显低于A型;M型的FEV₁%pred、FVC%pred、残气量/肺总量和急性加重方面均较A、E两型更差,但差异无统计学意义(P均>0.05)。结论 COPD患者的营养水平与肺功能、肺气肿程度、急性加重次数密切相关。胸部CT严重程度和表型评估可以为COPD分型和治疗提供有效的参考依据。