摘要
目的探讨能量型营养支持治疗对稳定期COPD患者营养状况、肺功能、急性发作和病死率等的疗效。方法通过联机检索，人工检索收集符合纳入标准的随机对照试验，利用固定和随机效应模型进行荟萃分析。结果最终10项随机对照试验的354例被纳入研究，以连续变量为效应指标来衡量疗效，体重、上臂肌围、肱三头肌皮褶厚度、FEV1和FVC的标准化均数差及其95％CI分别为0．05（-0．18—0．28）kg、-0．16（-0．57—0．25）cm、0．41（0．01—0．82）cm、0．04（-0．39—0．48）ml和0．03（-0．40—0．46）ml。结论 能量型营养支持对稳定期COPD患者的营养状况和肺功能改善无明显疗效。没有足够的证据证明能量型营养支持治疗可减少COPD急性发作或降低COPD病死率。不良反应主要为腹胀导致正常摄食减少。
Objective To conduct a meta-analysis of randomized controlled trials （RCTs） to clarify whether nutritional intervention （ caloric supplementation for at least 2 weeks） can improve the nutritional status and the pulmonary functions, while reduce the frequency of acute exacerbation or mortality of patients with stable COPD. Methods RCTs were identified from databases including Medline and Embase, and a hand search for references was also conducted. Two reviewers independently selected the trials for inclusion, assessed the methodological quality of each study, and extracted the data. Within each trial and for each outcome, an effect size was calculated. The effect sizes were then pooled by a random or fixed effects model according to the heterogeneity tested among the studies. Results From 143 references, 10 RCTs （including 354 participants） were included in this meta-analysis. The results of the study, which included body weight （BW）, mid arm muscle circumference （MAMC）, triceps skinfold thickness （TSF）, forced expiratory volume in one second （ FEV1 ） and forced vital capacity （ FVC）, were expressed in standardized mean difference （SMD, 95%CI）： 0.05 （ -0. 18 -0.28） kg, -0. 16 （ -0.57 -0.25） cm, 0.41 （0.01 - 0. 82） cm, 0. 04 （ - 0. 39 - 0. 48） ml and 0. 03 （ - 0. 40 - 0. 46） ml. The effect of energetic nutritional intervention for patients with stable COPD was insignificant; the 95% CI around the pooled effect sizes all included zero. Conclusion Nutritional intervention by caloric supplementation had no effect on improving the nutritional status and the pulmonary functions in patients with stable COPD. There was no evidence that the frequency of acute exacerbation or mortality could be reduced.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2008年第2期107-111,共5页
Chinese Journal of Tuberculosis and Respiratory Diseases
基金
上海市自然科学基金（05ZR14063）
关键词
肺疾病
慢性阻塞性
营养支持
META分析
Pulmonary disease, chronic obstructive
Nutritional support
Meta-analysis
