慢性阻塞性肺疾病(chronic obstructive pulmonary disease; COPD)是一個多重病因以及影響多重器官系統的發炎性疾病。而營養失調導致的體重下降更經常出現在COPD病患當中。COPD病患體重下降的原因爲代謝率過度旺盛、全身性的發炎反應等多項原因交互作用產生的結果。體重下降的表徵表示病患的骨骼呼吸肌肉失養,加重了病患呼吸困難的症狀,也使活動能力逐漸降低,最終造成失能的情形,更甚至於降低病患日後的存活率。本文獻回顧主要是探討COPD病患營養失調的病理機轉,如何正確的評估病患的營養狀態,以及如何給予病患適當的營養補充處方,輔以運動與合成性藥物,減少病患體重下降的機會,增進肌肉的力量與耐受性與力量,進而改善其生活品質。
Chronic obstructive pulmonary disease (COPD) is a multifactorial, multisystemic and inflammatory disease. Among exptrapulmonary manifestations of COPD, weight loss associated with nutritional depletion is a frequent complication. Malnutrition in these patients is due to multiple factors including increases in resting energy expenditure, a high systemic inflammation response, tissue hypoxia. immobility, aging process and drug usage. This problem adversely affects morbidity and mortality. This article covers the prevalence, pathogenesis and consequences of malnutrition in COPD and discusses how to perform a nutritional assessment in clinical practice. And finally address the implications of nutritional supplement including anabolic stimulus and exercise which appears to be the best approach to obtaining marked functional improvement as well as exercise performance and quality of life for COPD patients.