摘要
为了观察食欲刺激剂甲地孕酮（ｍｅｇｅｓｔｒｏｌａｃｅｔａｔｅ，ＭＡ）对慢性阻塞性肺病（ＣＯＰＤ）缓解期患者营养状况、呼吸肌力及免疫功能的影响，将３１例患者随机分为两组，治疗组１６例，口服ＭＡ１６０ｍｇ／ｄ；对照组１５例，口服多酶片３片。治疗前后测定饮食营养指标、肺功能、呼吸肌力和有关免疫学参数。２周后发现每日摄入热能和蛋白质有显著增加；人体测量值如体重、理想体重百分比、三头肌皮褶厚度、血清蛋白测定值、最大口腔吸气压、最大口腔呼气压、握力、６分钟行走距离、淋巴细胞直接计数、淋巴细胞转化率和肺活量占预计值百分比等的变化与治疗前比较，差异有显著性（Ｐ＜０．０１）。对照组１５例患者各项指标均无明显变化。用药后仅１例患者有轻微恶心呕吐。说明ＭＡ可改善ＣＯＰＤ缓解期患者营养状况、呼吸肌力及免疫功能。
Ithasbeenreportedthatmalnutritioniscommoninstablechronicobstructivepul-monarydisease(COPD)patients.InordertoobservetheefectsofMegestrolAcetate(MA)onnutri-tionalstatus,respiratorymusclestrengthandimmunologicalparametersinstableCOPDpatients,31stableCOPDpatientsweredividedintotwogroupsatrandom atreatmentgroupof16casesandacontrolgroupof15cases.Beforeandaftertreatmentalparameterswererecorded,includingfoodandenergyintake,bodyweight,tricepsskinfolds(TSF),pre-albumin,transferin,albumin.Lungfunc-tion,respirtorymuscleandhandgripstrengthwereexaminedandimmunologicalparametersalsodeter-mined.AftertakingMA160mg/dayoralyfortwoweeks,thetreatmentgroupgotbenefitsasfolows:heatenergyandproteinintakeincreasedfrom6977.9±1136.5kJ/dand44.65±13.75g/dto9854.0±2355.3kJ/dand84.80±20.23g/drespectively.Withtheincreaseofdailyenergyandproteinintake,bodyweightincreasedfrom48.27±8.61kgto50.34±8.76kg,TSFfrom11.75±4.50mmto15.06±4.73mm,serumpre-albuminfrom306.6±33.7mg/Lto332.6±38.1mg/L,transferinfrom3.09±0.21g/Lto3.46±0.32g/L,albuminfrom38.00±1.73g/Lto42.64±3.36g/L,MIPfrom4.77±2.14kPa(1kPa=7.5mmHg)to6.31±2.87kPa,MEPfrom6.21±2.90kPato7.20±3.67kPaand6min-uteswalkingdistancefrom280.2±76.4mto370.6±81.5m.Handgripstrengthalsoimproved.Bloodlymphocytecountandlymphocytetransformationrateelevatedtoo.(Thechangesofaltheseparame-tersindicatedabovewerestatisticalysignificant,P<0.01).However,parametersoflungfunction,bloodgasanalysis,serumimmunoglobulinandcomplement3didnotchangesignificantly.In15controlpatientsaltheparametersdidnotchangesignificantly.Therewerefewsideefects;onlyonecasecom-plainedofnauseaandvomiting.ItwasshownthatMAcanstimulateappetiteandincreasedietintake,improvenutritionalstatus,elevaterespirtorymusclestrength,andenhanceimmunity.MAisasafeandefectivedrugwhichexertsabeneficialinfluenceonstableCOPD.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1996年第7期466-470,共5页
Chinese Journal of Internal Medicine
基金
国家"八五"攻关基金
