Ayşegül EREN, Elif TORUN, Nesrin KIRAL, Banu SALEPÇİ, Ali FİDAN, Benan ÇAĞLAYAN

The effect of body mass index on functional parameters and quality of life in COPD patients

Kronik obstrüktif akciğer hastalığı (KOAH) olan hastalarda malnütrisyon, solunum kas gücünde bozukluğa yol açarak dispne ve egzersiz intoleransını daha belirgin hale getirir, yaşam kalitesini bozar. Çalışmamızda, düşük ve normal beden kitle indeksi (BKİ)’ne sahip stabil KOAH hastalarında dispnenin ciddiyeti, solunum fonksiyon testleri (SFT), arter kan gazları (AKG), solunum kas gücü indeksi, egzersiz kapasitesi (EK) ve yaşam kalitesi (YK) açısından farklılık olup olmadığı prospektif olarak incelendi. Nisan 2003-Haziran 2004 tarihleri arasında çalışmaya alınan 65 KOAH’lı hastanın yaş ortalaması 63.4 ± 9.6 olup, tümü erkekti. Olgular, BKİ < 21 olanlar (grup 1) ve BKİ= 21-28 olanlar (grup 2) olmak üzere iki gruba ayrıldı. Tüm olgulara SFT (spirometrik ölçümler, maksimum inspiratuar ve ekspiratuar basınçlar, difüzyon testi), AKG ölçümü, “Modified Medical Research Counsil (MMRC)” dispne skalası ile dispne skorlaması, altı dakika yürüme testi (6 DYT) ile EK belirlenmesi, “St. George Respiratory Questionaire (SGRQ)” Türkçe versiyonu ile YK değerlendirilmesi yapıldı. Olguların 29 (%44.6)’u düşük, 36 (%55.4)’sı normal BKİ’ye sahip olup, MMRC dispne skoru birinci grupta daha yüksek olmakla birlikte bu fark istatistiksel olarak anlamlı değildi (p= 0.074). Birinci grupta difüzyon kapasitesi (DLCO) ve %DLCO değerleri, solunum kas gücü parametrelerinden PEmax, %PEmax, solunum kas gücü indeksi (Respiratory Muscle Strength= RMS), %RMS değerleri anlamlı derecede düşük bulundu (p< 0.05). AKG değerleri, 6 DYT sonuçları ve SGRQ semptom skorlarında iki grup arasında farklılık tespit edilmedi. Sonuç olarak; KOAH’lı hastalarda BKİ ile dispne düzeyi ve solunum kas gücü yakından ilişkili olup, BKİ düşük olgularda medikal tedavinin yanı sıra nütrisyonel desteği de içeren pulmoner rehabilitasyon programlarının uygulanması önemlidir.

KOAH’ta beden kitle indeksi ile fonksiyonel parametreler ve yaşam kalitesi arasındaki ilişki

Malnutrition increases dyspnea and exercise intolerance in chronic obstructive pulmonary disease (COPD) patients by effecting respiratory muscle strength (RMS) and thereby decreasing quality of life (QoL). This is a prospective study conducted to find out the differences due to pulmonary function tests (PFT), arterial blood gases (ABG), RMS, exercise capacity (EC) and QoL in COPD patients having low and normal body mass index (BMI). The study was carried out between April 2003-June 2004 and included 65 male COPD patients with a mean age of 63.4 ± 9.6. The patients were grouped into 2: Low BMI group (BMI < 21) and normal BMI group (BMI= 21-28). All patients were investigated with PFT (spirometry, maximal inspiratory and expiratory pressures, diffusion capasity), ABG analyses, Modified Medical Research Council (MMRC) dyspnea scale, determination of EC by 6 minutes walking test (6 MWT) and determination of QoL by Turkish version of St. George Respiratory Questionnaire (SGRQ). Of these cases, 29 (44.6%) had low and 36 (55.4%) had normal BMI; MMRC was higher in the first group without statistical significance (p= 0.074). The first group demonstrated significantly lower diffusion capacity (DLco) and DLco%, PEmax, PEmax%, RMS and RMS% (p< 0.05). ABG analyses, 6 MWT results and SGRQ symptom scores revealed no significant difference. As a conclusion, BMI is closely related to dyspnea score, RMS and QoL in COPD patients, therefore in patients with low BMI pulmonary rehabilitation programs including nutritional support should accompany medical treatment.

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