肺気腫患者の除脂肪組織量と肺機能,筋力,運動能との関連の検討

Abstract

The purpose of this study was to investigate changes of body composition in patients with pulmonary emphysema (PE) and their influence on physiological function. Body composition analysis by means of bioelectrical impedance analysis (BIA) was performed in 36 patients with stable PE and 19 age-matched healthy controls. I compared fat free mass (FFM) and body fat (BF), as a percentage of ideal body weight (FFM/IBW, BF/IBW), between patients with PE and healthy controls. FFM/IBW and BF /IBW were significantly lower in patients with PE than those in healthy controls. In patients with PE, both FFM/IBW and BF/IBW were significantly correlated with the indices of anthropometry, arm muscle circumference and triceps skin fold as a percentage of ideal value. FFM was significantly correlated with %VC, %FEV1, FEV1/FVC, %DLco and %DLco/VA, but BF/IBW was not related with any measures of lung function. I divided the patients with PE into two subgroups according to their FFM, then investigated the relationship between FFM and skeletal muscle strength, respiratory muscle strength and exercise performance. In patients with reduced FFM (FFM/IBW＜78%) grip strength as an index for skeletal muscle strength was significantly lower than in patients without reduction of FFM (FFM/IBW≧78%). Maximal inspiratory pressure as an index for respiratory muscle strength and ten minutes walking distances were also significantly lower than those in patients without reduction of FFM. In this study I have shown that the reduction of FFM is related with impaired physiologi- cal function in patients with PE. From the results of this study I suggest that an increase of FFM should be a goal in its clinical management, and that body composition assessment is important to make a plan of nutritional therapy in patients with PE.