| Summary: | 碩士 === 靜宜大學 === 食品營養學系 === 82 === This study demonstrated clinical improvement in COPD patients by different fat formula diets of nutritional intervention. We choiced the samples including 80 COPD patients with FEV1/FVC%<70 % or patients who were in respiratory failure due to COPD and were supported by ventilatory apparatus (excluding the patients of liver and (or) kidney failure) from March 1993 to April 1994 at the Kaohsiung Medical College Hospital (KMCH).Every case was under nutritional intervention for 21 days. They were under the assessment of nutritional status 24 to 48 hours after admission by 24 hour's dietary recall method to assess three day diet intake before admission. Then we took the mean value to process nutri- tional assessment. The diet intake was individually designed and supplied by tube-feeding. The patients were divided into three groups according to the differences off at formula diet which was also tolerated by the patients. The first group was supplied by 35% fat diet, the second group by45%, and the third group by 50% or above. The diet intake was increased evidently in all of tested groups after nutritional intervention, except the carbo- hydrate in the third group. Some items were analysized before and after nutritional intervention, including: anthropometry, pulmonary function, arterial blood gas, biochemical test and immune function. We should analyze the prognostic effects by different fat formula diets. The nutritional indexs (NI and PNI) were used for comparing the nutritional status before and after nutritional intervention. The results were summarized as following:
1. Anthropometry: The value of the data increased after nutritional intervention in the 35% and 45% fat diet groups. The value of the third group was not significant difference.
2. Pulmonary function:
Although the FEVIIFVC% of 35% fat diet group was not improved, it was increased significantly in the high fat diet groups 45% and 50% or above diet formula after nutritional intervention. These showed that the high fat diet would improve the patient's pulmonary obstructive impairment, but it was not significant difference between these two high fat diet groups.
3. Arterial blood gas:
The PaCû2 was increased in 35% fat diet group after nutritional intervention but decreased in the high fat diet groups.
4. Biochemical test:
The blood levels of cholesterol and triglyceride did not change in all groups after nutritional intervention. The serum total protein, ablumin, pre-albumin, transferrin and phosphorus revealed no change in the 35% fat diet group after nutritional intervention; but the high fat diet groups showed improvement. CHI and nitrogen balance were improved after nutritional intervention in all groups
5. Immune function:
The C3, C4 and total lymphocyte count were increased in 45% and 50% or above fat diet gr.oups after nutritional intervention.
6. Nutritional index (NI and PNI):
The nutritional index (NI) and prognostic nutritional index (PNI) were assessed. The results demostrated significant improvement after nutritional intervention in all groups. The nutritional status have been improved after nutritional intervention in all groups. The pulmonary function, PaC02 and
blood phosphorus were significantly improved in the high fat diet groups. The blood levels of cholesterol and triglyceride were not increased by supplying high fat diet. It would not cause hyperlipidemia. The fat component of diet might be increased to the tolerance limits of COPD patients. The 45% fat diet group showed the best tolerance in all groups from the results of this study. We propose that the 45% fat diet might be a more appropriate diet formula for COPD Chinese patients.
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