Study on relation of respiratory muscle strength, leg muscle strength and nutritional status in patients with chronic pulmonary emphysema

肺気腫患者16例の呼吸筋力，下肢筋力，栄養状態の関連を検討した．肺気腫患者は呼吸筋力が低下し，呼気口腔内圧積分値，平均呼気口腔内圧と体重，除脂肪体重，除脂肪体重／標準体重の間に有意の相関が認められた．やせ群は非やせ群より呼気筋力，吸気筋力とも低下しており，呼気筋力で有意差が認められた．下肢筋力低下群は非低下群より呼気筋力，吸気筋力とも低下しており，吸気筋力で有意差が認められた．以上より，肺気腫患者に対する栄養療法と下肢筋力トレーニングは呼吸筋力の改善に有効である可能性が示唆された．また，肺気腫患者の栄養評価指数として除脂肪体重が，呼吸筋力評価指数として，最大口腔内圧とともに口腔内圧積分値と平均口腔内圧が有用であることが示された．The respiratory muscle strength, leg muscle strength, and nutritional status were examined in 16 patients with chronic pulmonary emphysema. The respiratory muscle strength decreased, and the integral expiratory pressure (PEinteg) and the average expiratory pressure (PEave) were significantly correlated with body weight, fat free mass (FFM). Expiratory pressures, PEinteg, PEave and PEmax, were significantly lower in the malnourished patients than in the normonoutrished patients. Inspiratory pressures, PImax and PIave, were significantly lower in the group of decreased leg strength than non-decreased groups. These results suggested that the nutritional care and the leg muscle strength training may effective to improve the respiratory muscle strength of the patients with chronic pulmonary emphysema. It was also suggested that FFM was useful to assess the nutritional status, and that integral or average respiratory pressures, as well as maximal respiratory pressure, were useful to assess the respiratory muscle function