COPD患者维生素B1的营养状况及其相关预后分析

摘要

目的：研究慢性阻塞性肺疾病( COPD)患者的维生素B1营养状况,并分析其与相关预后的相关性。方法选择我院2011年1月~2013年12月呼吸科诊断的COPD稳定期患者125例作为研究组,选取我院体检中心健康体检的健康人72例作为对照组。采用高效液相色谱法测定血液中维生素B1含量、尿液中维生素B1的含量；使用肺功能仪检测肺功能；采用汉密尔顿抑郁量表和汉密尔顿焦虑量表测试抑郁焦虑程度；采用超声心动图测定右心室内经( RVD)、右心室内经( RAD)、右心室射血分数( RVEF)、三尖瓣环收缩期位移(TAPSE)。结果与对照组比较,COPD组血液、尿液中 TDP含量明显降低,差异有统计学意义(P<0．01)。 COPD稳定期患者抑郁分数为(56．3±30．5)分,61例(48．8%)有抑郁情绪,对照组抑郁分数为(41．7±22．3)分,15例(20．8%)有抑郁情绪,两组比较差异有统计学意义(P<0．05)。 COPD组焦虑分数为(65．3±25．1)分,67例(53．6%)有焦虑情绪,对照组焦虑分数为(53．7±24．6)分,19例(26．4%)有焦虑情绪,两组比较差异有统计学意义(P<0．05)。 COPD组按抑郁焦虑程度进行分组,发现抑郁焦虑程度越重,血液、尿液中维生素B1含量越低,组间比较差异有统计学意义(P<0．05)。 COPD患者血液TDP含量、尿液TDP含量与右心功能各指标均无明显相关性(P>0．05)。结论 COPD患者体内维生素B1缺乏普遍而且严重,COPD患者抑郁和焦虑发病率显著上升可能与维生素B1缺乏有关。因此,给COPD患者及时补充维生素B1可能改善生活质量及预后。%Objective To study the nutritional status of vitamin B1 in patients with chronic obstructive pul-monary disease ( COPD) and to analyze its correlation between vitamin B1 deficiency and prognosis. Methods 125 patients with stable COPD were selected as the research group, and 72 healthy people as the control group. High per-formance liquid chromatography method was used to determinate vitamin B1 level in blood and urine, and lung func-tion instrument to detect lung function. The Hamilton depression rating scale and Hamilton anxiety scale were used to test depression anxiety. RVD, RAD, RVEF and TAPSE were determined by thoracic echocardiography. Results Compared with the control group, the level of TDP decreased obviously in blood and urine (P<0. 01). The depres-sion score of stable COPD patients was 56. 3 ± 30. 5, 61 cases of which (48. 8%) had depression, while it was 41. 7 ± 22. 3 in the control group, 15 cases of which (20. 8%) had depression (P<0. 05). The anxiety score was 65. 3 ± 25. 1 in the research group, and 67 cases of them had anxiety. The anxiety score was 53. 7 ± 24. 6 in the control group, and 19 cases had anxiety (P<0. 05). According to the degree of depression and anxiety in the COPD group, it was found that the heavier the depression anxiety was, the lower the vitamin B1 level was in blood and urine ( P<0. 05). There was no statistical significance between blood or urine TDP levels and right cardiac function (P >0. 05). Conclusion COPD patients are lack of vitamin B1, and the incidence of COPD patients with depression and anxiety may be associated with vitamin B1 deficiency. Therefore, timely supplement of vitamin B1 for patients with COPD can improve their quality of life and prognosis.