慢性阻塞性肺疾病住院患者营养状况和远期病死率的关系

目的 探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)住院患者的营养状况和远期病死率的之间的相关性。方法 2015年1月至2016年7月我院收治COPD患者82例，采用回顾性分析方法收集患者的临床资料，按照BMI水平高低将患者分为营养正常组（49例）和营养不良组（33例）。对两组患者的营养状态、肺功能、住院时间以及远期病死率进行比较。结果 营养不良组患者的血清白蛋白（album, ALB）、血清前白蛋白（prealbumin, PAB)以及血淋巴细胞计数(lymphocyte count, TLC)水平明显低于营养正常组患者（P<0.05）。营养不良组患者的肺功能呼气峰流速（peak expiratory flow, PEF）、第一秒用力呼气容积（ forced expiratory volume in 1st second，FEV1）、一秒用力呼气容积/用力肺活量百分比（FEV1/FVC）水平均显著低于营养正常组患者（P<0.05）。营养不良组住院时间以及远期病死率均显著大于营养正常组（P<0.05）。患者BMI与肺功能的PEF、FEV1、FEV1/FVC呈正相关（P<0.05），Spearman等级相关分析结果显示，患者的BMI水平与远期病死率有负相关关系（P<0.05）。结论 COPD患者的营养状况与肺功能的改善及预后的良好恢复密切相关，营养不良者远期病死率增加。

Relationship between nutritional status and long term mortality of inpatients with chronic obstructive pulmonary disease

Objective To explore the correlation between nutritional status and long term mortality of inpatients with chronic obstructive pulmonary disease(COPD). Methods From January 2015 to July 2016, 82 patients with COPD were admitted to our hospital. The clinical data of patients were collected by retrospective analysis. The patients were divided into normal nutrition group (49 cases) and malnutrition group (33 cases) according to the level of BMI.The nutritional status, pulmonary function, hospital stay and long term mortality of two groups were compared. Spearman correlation analysis was used to explore the relationship between the nutritional status of patients and the long term mortality. Results The levels of serum albumin（ALB）, prealbumin（PAB）and blood lymphocyte count（TCL） in malnutrition group were significantly lower than those in normal nutrition group（P<0.05）. The levels of peak expiratory flow（PEF）, forced expiratory volume in 1st second（FEV1）and FEV1/FVC in malnutrition group were significantly lower than those in normal nutrition group（P<0.05）. The length of hospital stay and long term mortality of patients in malnutrition group were significantly higher than those in normal nutrition group（P<0.05）. Spearman correlation analysis showed that BMI was positively correlated with PEF, FEV1 and FEV1 / FVC of lung function（P<0.05）, and BMI was negatively correlated with long term mortality（P<0.05）. Conclusion The nutritional status of COPD patients is closely related to the improvement of pulmonary function and the good recovery of prognosis. The long term mortality of malnourished patients increases.