Efficacy Evaluation Of Oral Nutritional Supplements In Stable COPD Patients

Background:Chronic obstructive pulmonary disease(COPD)is a heterogeneous pulmonary condition characterized by high prevalence rate,high disability rate,high mortality rate and low awareness rate.Malnutrition is one of the common complications of COPD and can further aggravate the disease.Nutritional risk screening in patients with COPD can timely detect patients with nutritional risk,and early nutritional intervention can improve the quality of life and prognosis of patients.Inflammatory response plays an important role in the occurrence and development of COPD dystrophy.Studies have shown that inflammatory factors and protein levels are correlated with nutritional risk.Therefore,it is clinically feasible and effective to explore blood biochemical indicators that can be used to assess nutritional risk.In addition,nutritional support therapy has attracted more and more attention from researchers,and it plays a positive role in improving patients’ nutritional status,increasing body weight,improving muscle strength,reducing inflammatory response,etc.However,the therapeutic effect of COPD patients at different periods has not been very clear,so it is necessary to explore the efficacy of nutritional support therapy in stable COPD patients.Objectives:This study aims to analyze the correlation between nutritional risk and blood biochemical indexes in COPD patients,and explore the related indexes that can be used to evaluate the occurrence of nutritional risk in COPD patients.To investigate the effect of oral nutritional supplement in comprehensive treatment of stable COPD patients.Methods:Included were COPD patients admitted to the respiratory Department outpatient Department of the Second Affiliated Hospital of Guangzhou Medical University from January 2022 to June 2022.Demographic data,NRS-2002 score,blood biochemical test indicators and follow-up data of the included patients were collected and statistically analyzed.In the first part,a total of 171 patients with stable COPD were included,who were divided into nutritional risk group and non-nutritional risk group according to whether or not NRS-2002 score was ≥3.To analyze the nutritional status of stable COPD patients in our hospital.The correlation between nutritional risk score and blood biochemical indexes was analyzed.logistic regression analysis and ROC analysis were used to explore the blood biochemical indicators that could be used to assess the occurrence of nutritional risk in COPD patients.In the second part,a total of 75 patients with stable COPD were included and divided into observation group and control group according to whether oral nutritional supplements were used.Selfpaired T-test was used to analyze the changes of body composition,CAT score,m MRC score and hospitalization times of acute exacerbation in COPD patients before and after nutritional treatment.The t test of two independent samples was used to analyze the difference between the observation group and the control group in the number of hospitalizations due to acute exacerbations after nutritional treatment.P <0.05 was considered statistically significant.Results:1.Nutritional risk scores were correlated with body weight,BMI,hemoglobin,lobular cell count,lymphocyte count,C-reactive protein,albumin,and CAR(p <0.05),and nutrition-risk COPD patients had higher levels of inflammation and lower levels of albumin.Anemia,increased proportion of lobed cells,decreased proportion of lymphocytes,increased C-reactive protein,decreased albumin,and older age are risk factors for the development of nutritional risk.C-reactive protein(ROC area0.7153),albumin(ROC area 0.8023)and CAR(ROC area 0.7274)had certain predictive value for nutritional risk,and could be used to evaluate the nutritional risk in patients with stable COPD.2.Compared with before treatment,after 6 months of conventional treatment combined with oral nutritional supplements,the body weight,BMI,subscapular fold thickness,triceps fold thickness and grip strength of COPD patients in the observation group were significantly improved,m MRC score and CAT score were significantly decreased,and the number of hospitalizations for acute exacerbations was significantly reduced,with statistical significance(p < 0.05).Control group of COPD patients maintained normal daily diet and conventional treatment plan,6 months later,there was no statistical significance in the number of acute exacerbation hospitalization between the two groups(p > 0.05).Conclusions:1.Outpatient COPD patients at nutritional risk had higher levels of inflammation and poorer nutritional status.2.Anemia,increased proportion of lobed cells,decreased proportion of lymphocytes,increased C-reactive protein,decreased albumin and the elderly are risk factors for nutritional risk.C-reactive protein,albumin and CAR have certain predictive value for nutritional risk and can be used to assess nutritional risk in patients with COPD.3.Oral nutritional supplement treatment can reduce clinical symptoms,improve physical fitness and improve quality of life in patients with stable COPD.4.Oral nutritional supplement therapy may have a protective effect on reducing hospitalization due to acute exacerbations in patients with stable COPD.