营养不良被认为与COPD患者的不良预后有关。去脂体重(FFM)减少和较低的BMI已经被认为是增加COPD患者死亡率的独立危险因素。国内外许多研究均强调营养风险筛查及营养干预对COPD患者的必要性及有效性,最新的COPD指南提及可根据患者的静息能量消耗(REE)进行核算,根据患者的营养状况、病情严重程度、能量消耗情况,规划患者的营养摄入,制定相应的食谱。但就我国住院患者营养风险的常规筛查在临床未普及且具体的干预措施待制定。本文在上述现状基础上简述了COPD患者发生营养不良的机制、营养不良对COPD患者的影响,介绍了COPD患者营养状况的评估方法及目前提倡的COPD患者的营养干预方式。旨在为引起临床工作者对于COPD患者营养问题的重视及为进一步开展COPD伴发营养不良人群的营养筛查及干预提供参考。
Malnutrition is thought to be associated with poor prognosis in patients with COPD. Reduced fat-free body weight (FFM) and lower BMI have been identified as independent risk factors for increased mortality in patients with COPD. Many studies at home and abroad stressed nutritional risk screening and the necessity and effectiveness of the nutritional intervention for patients with COPD. The latest COPD guidelines suggest calculations based on a patients’ resting energy expenditure (REE). According to the nutritional status, severity of the disease, energy consumption of patients, plan the nutritional intake of patients, and develop the corresponding diet. However, routine screening of nutritional risk for inpatients in China is not widely used in clinic and specific interven-tion measures need to be formulated. Based on the above, this paper briefly described the mecha-nism of malnutrition in COPD patients and its impact on COPD patients, and further introduced the evaluation methods of the nutritional status of COPD patients and the nutritional intervention methods currently advocated for COPD patients. This study aims to provide reference for clinical workers to pay attention to the nutritional problems of COPD patients and to further carry out the nutritional screening and intervention of COPD patients with malnutrition.
Research Progress in Pathogenesis, Nutritional Evaluation and Nutritional Intervention of Chronic Obstructive Pulmonary Disease Associated Malnutrition
Jilian Li1, Mao Hua2*
1Graduate School of Qinghai University, Xining Qinghai
2Qinghai University Affiliated Hospital, Xining Qinghai
Malnutrition is thought to be associated with poor prognosis in patients with COPD. Reduced fat-free body weight (FFM) and lower BMI have been identified as independent risk factors for increased mortality in patients with COPD. Many studies at home and abroad stressed nutritional risk screening and the necessity and effectiveness of the nutritional intervention for patients with COPD. The latest COPD guidelines suggest calculations based on a patients’ resting energy expenditure (REE). According to the nutritional status, severity of the disease, energy consumption of patients, plan the nutritional intake of patients, and develop the corresponding diet. However, routine screening of nutritional risk for inpatients in China is not widely used in clinic and specific intervention measures need to be formulated. Based on the above, this paper briefly described the mechanism of malnutrition in COPD patients and its impact on COPD patients, and further introduced the evaluation methods of the nutritional status of COPD patients and the nutritional intervention methods currently advocated for COPD patients. This study aims to provide reference for clinical workers to pay attention to the nutritional problems of COPD patients and to further carry out the nutritional screening and intervention of COPD patients with malnutrition.
Keywords:Chronic Obstructive Pulmonary Disease (COPD), Pathogenesis, Nutritional Assessment, Nutritional Support
李吉莲,华 毛. 慢阻肺相关性营养不良发病机制、营养评估及营养干预的研究进展Research Progress in Pathogenesis, Nutritional Evaluation and Nutritional Intervention of Chronic Obstructive Pulmonary Disease Associated Malnutrition[J]. 临床医学进展, 2022, 12(06): 5319-5326. https://doi.org/10.12677/ACM.2022.126771
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