Stanje prehranjenosti in telesna sestava bolnikov s kronično obstruktivno pljučno boleznijo

Benedik, Barbara

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Title:	Stanje prehranjenosti in telesna sestava bolnikov s kronično obstruktivno pljučno boleznijo
Authors:	ID Benedik, Barbara (Author) ID Lainščak, Mitja (Mentor) More about this mentor... ID Hlastan Ribič, Cirila (Comentor)
Files:	MAG_Benedik_Barbara_2012.pdf (736,00 KB) MD5: D307BA5319A9CB0602A8931335E14BED PID: 20.500.12556/dkum/e633b1cb-c3b1-4ed9-a53b-c8d08cae4325
Language:	Slovenian
Work type:	Master's thesis/paper
Typology:	2.09 - Master's Thesis
Organization:	FZV - Faculty of Health Sciences
Abstract:	Izhodišča. Kronična obstruktivna pljučna bolezen (KOPB) je kronično, počasi napredujoče bolezensko stanje s pospešeno in nepopravljivo izgubo pljučne funkcije. Poleg dihal prizadene tudi ostale organske sisteme. Značilna zanjo je izguba telesne, predvsem mišične mase, in spremembe v stanju prehranjenosti. Namen. Pri bolnikih s KOPB smo želeli oceniti stanje prehranjenosti in telesno sestavo bolnikov ter rezultate primerjati s kontrolno skupino zdravih preiskovancev primerljive starosti in spola. Prav tako smo želeli ugotoviti, ali obstaja povezanost med stanjem prehranjenosti, telesno sestavo in bolnikovimi simptomi ter stopnjo samooskrbe. Raziskovalna metodologija. V prospektivno raziskavo smo vključili 65 bolnikov s hudo ali zelo hudo KOPB (71 ± 7 let, 60 % moških). V kontrolni skupini je bilo 22 preiskovancev (71 ± 5 let, 59 % moških). Iz medicinske dokumentacije smo povzeli podatke o demografskih značilnostih in sočasnih obolenjih. V stabilni fazi smo preiskovancem opravili preiskavo pljučne funkcije, meritve telesne sestave in antropometrične meritve. Z vprašalniki smo ocenili stanje prehranjenosti, naredili oceno kategorije zahtevnosti zdravstvene nege in oceno sposobnosti samooskrbe preiskovancev ter oceno stopnje dispneje. Podatke smo analizirali s programom SPSS 18.0 (SPSS INC, 2010, ZDA). Numerične spremenljivke smo predstavili s srednjo vrednostjo in standardnim odklonom. Kategorične spremenljivke smo predstavili z absolutnim številom in odstotkom. Razlike med spremenljivkami smo analizirali s Studentovim t-testom, Mann-Whitneyjevim u-testom in testom hi-kvadrat. Morebitne povezave med spremenljivkami smo ocenjevali z metodo korelacije ter metodo enostavne in multiple logistične regresije. Rezultati. Bolniki s KOPB imajo nižji ITM kot kontrolna skupina (p = 0,016). Ugotovili smo, da je bilo le 18 (28 %) bolnikov s KOPB dobro hranjenih. Korelacija stopnje prehranjenosti med bolniki s KOPB po klasifikaciji po GOLD je bila statistično značilna (p = 0,034). Značilno sta se skupini kontrolnih preiskovancev in bolnikov s KOPB razlikovali v parametrih telesne sestave, in sicer v pusti teži (80 ± 14 vs 72 ± 17, p = 0,029) in celokupni telesni vodi (42 ± 8 vs 38 ± 8, p = 0,025) ter stanju prehranjenosti (p < 0,001). Višja stopnja dispneje, izmerjene po MMRC (2.–5.), je bila mejno povezana z nižjo oceno stanja prehranjenosti bolnika (p = 0,053). Pri bolnikih z višjo stopnjo zahtevnosti kategorizacije zdravstvene nege in z višjo stopnjo lestvice LOSS je bilo stanje prehranjenosti slabše. Sklep. Bolniki s KOPB so slabše prehranjeni kot preiskovanci iz kontrolne skupine. Stanje prehranjenosti je bilo slabše pri bolnikih, ki so imeli višjo stopnjo kategorizacije zahtevnosti zdravstvene nege. Ocena stanja prehranjenosti je pomembna in potrebna za preprečevanje podhranjenosti in pravočasne prehranske intervencije pri bolnikih s KOPB.
Keywords:	prehranjenost, KOPB, telesna sestava, stopnja samooskrbe, dispneja
Place of publishing:	Maribor
Publisher:	[B. Benedik]
Year of publishing:	2012
PID:	20.500.12556/DKUM-39086
UDC:	616.24
COBISS.SI-ID:	1863332
NUK URN:	URN:SI:UM:DK:D6SYARRK
Publication date in DKUM:	13.12.2012
Views:	3910
Downloads:	493
Metadata:
Categories:	FZV
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Secondary language

Language:	English
Title:	Nutritional status and body composition in patients with chronic obstructive pulmonary disease
Abstract:	Background. Chronic obstructive pulmonary disease (COPD) is a chronic, slowly progressive clinical condition with a rapid and irreversible loss of lung function. Besides respiratory organs it affects other organic systems. It is characterized by loss of body mass, mostly muscle mass, and changes in nutritional status. Aim. In COPD patients we wanted to assess the nutritional status and body composition of patients and the results compare with the control group of healthy subjects of comparable age and sex. We also wanted to find out whether there is a connection between nutritional status, body composition, and the patient's symptoms and the degree of self-sufficiency. Methods. In our prospective study we included 65 patients with severe or very severe COPD (71 ± 7 years, 60 % men). The control group included 22 subjects (71 ± 5 years, 59 % men). From medical records we summarized the data on the demographic characteristics and contemporary diseases. In the stable phase we carried out pulmonary function measurements of body composition and anthropometric measurements in subjects. With the questionnaires were evaluated nutritional status, it was made the assessment of nursery skill level category, the assessment of the subjects’ self-care, and the degree of dyspnoea. We analyzed the data by using SPSS 18.0 (SPSS Inc., 2010, USA). We presented numeric variables with median value and standard deviation. Categorical variables were presented with the absolute number and percentage. Differences between variables were analyzed by using Student's t-test, Mann-Whitney U-test and Chi-square. We evaluated potential links between variables with correlation method and the method of simple and multiple logistic regression. Results. Patients with COPD have a lower BMI than the control group (p = 0.016). We found out that there were only 18 (28 %) patients with COPD well fed. The correlation of the nutrition level in patients with COPD by the Classification by GOLD was statistically significant (p = 0.034). Typically the two groups of control subjects and patients with COPD were different in parameters of body composition, namely in plain weight (80 ± 14 vs. 72 ± 17, p = 0.029), total body water (42 ± 8 vs 38 ± 8, p = 0.025), and nutritional status (p <0.001). Higher degree of dyspnoea as measured by the MMRC (2–5) was marginally linked with the lower nutritional status assessment of the patient (p = 0.053). In patients with a higher nursery skill level categorization and higher LOSS scale level the nutritional status was worse. Conclusion. Patients with COPD are less fed than control subjects. The nutritional status was worse in patients who had a higher nursery skill level categorization. The assessment of nutritional status is important and necessary to prevent malnutrition and timely nutritional interventions in patients with COPD.
Keywords:	nourishment, COPD, body composition, self-sufficiency level, dyspnoea

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