[An analysis of nutritional status and pulmonary hypertension in patients with sequela of pulmonary tuberculosis and chronic obstructive pulmonary disease].
The prognostic value of hypercapnia and/or pulmonary hypertension differs in patients with sequela of pulmonary tuberculosis (TBseq) and those with chronic obstructive pulmonary disease (COPD) who are receiving home oxygen therapy (HOT). In an attempt to identify the factors, if any, that might explain this difference, we first compared nutritional status, respiratory function test results, dyspnea indexes, and other data for hypercapnic patients (PaCO2 > or = 45 Torr) and normocapnic patients (PaCO2 < 45 Torr) receiving HOT. Second, we examined the relationship between the degree of pulmonary hypertension and several respiratory function parameters for patients in each disease category. In 44 patients with TBseq, nutritional status estimated by body mass index and serum albumin was significantly better in the hypercapnic patients than in the normocapnic patients. However, this difference was not observed in 37 patients with COPD. In 30 patients with TBseq, the degree of pulmonary hypertension correlated significantly only with PaO2; in 32 patients with COPD, however, significant correlations were observed not only with PaO2 but also with PaCO2, %VC, and FEV1. These differences distinguishing groups of patients with the 2 diseases may provide an explanatory basis for the difference in prognostic value of hypercapnia and/or pulmonary hypertension in patients receiving HOT.
Saito
H
H
First Department of Medicine, Hokkaido University.
Nishimura
M
M
Miyamoto
K
K
Kishi
F
F
Aida
A
A
Amishima
M
M
Nishiura
Y
Y
Miyamoto
H
H
Kirisawa
T
T
Yoshikawa
T
T
Shida
A
A
Kawakami
Y
Y
D000368:Aged; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000150:complications*; D006976:Hypertension, Pulmonary / Q000150:complications*; D008173:Lung Diseases, Obstructive / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010102:Oxygen Inhalation Therapy; D011379:Prognosis; D012648:Self Care; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000503:physiopathology