Effect Of Nutritional Support Therapy On Immune And Pulmonary Function In Patients During Acute Exacerbation Of COPD

Objective To explore the effect of nutritional support in treating patients during acute exacerbation of Chronic obstructive pulmonary disease (COPD) , including clinical effects, immune and pulmonary function. Methods 60 patients with COPD( acute aggravating episode with malnutrition ) were randomly divided into two group: parenteral nutrition ( PN )group and control group. The control group (30 cases ) receiving usual treatment ,including treating pulmonary infection, dispelling sputum, and remedying disequilibrium of Acid-Alkali and electrolyte disturbance. The daily dietary consumption of calories was 106.5 -115.8 kJ/kg ?d"1, nitrogen 0.15g/kg ?d~'; and the PN group ( 30 cases ) receiving parenteral nutritional treatment of Co-AA and 10% intralipid in addition to the routine treatment and the daily diet, the daily consumption of calories provided was 120.6-125.3·g d-1 , nitrogen 0.15-0.20 g/k·g d-1 altogether. Results (1) Clinical effects: two weeks of PN support later, valid rate of PN group was93.3%, control group 70.0%, X2=4.01 ( P<0.05 ). (2) Anthropometric measurement and biochemical testing : two weeks of PN support later, IB W% of PN groupincreased from ( 75.9±4.2 )% to ( 79.1±4.7 )% ( P<0.05 ) , TSF , MAMC and blood serum albumin of PN group were also significantly increased( P<0.05 ), but control group did not significantly altered( P>0.05 ) . (3) Measurements of immune function : two weeks of PN support later , the volume of blood TLC , CD3 > CD4 > ratio of CD4/CD8 and IgA of PN group were significantly increased ( P<0.05 ). In the control group, no significant difference was found except blood TLC. (4) Measurements of pulmonary function and arterial blood gas : two weeks of PN support later, FVC, FEV,/FVC, PaO2 and PaCO2 of PN group were significantly improved ( P<0.05 ) , but control group did not significantly altered from the beginning to the end of 2 weeks ( P>0.05 ). Conclusion : Nutritional support is one of the important measures in the comprehensive treatments ,which can improve the nutritional status , clinical effect , immune and pulmonary function in patients during acute exacerbation of COPD , and which is propitious to postpone the deterioration and to improve the prognosis in malnutritional patients with COPD.