- 學位論文
中風患者身體組成與肺功能變化之分析
Analysis of the Changes of Body Composition and Lung Function in Stroke Patients
摘要
目的:本研究目的在評估不同時期的中風患者之身體組成與肺功能，探討中風病患身體組成與肺功能變化的相關性，並分析不同殘障等級的中風患者其肺功能與身體組成的相關性。 方法:徵召72位腦中風患者為受試者來源，病患的年齡分佈為37至81歲，中風發生時間範圍為五天至三年。使用生物電子阻抗儀(InBody 3.0)進行身體組成分析，肺功能測試乃採用肺功能測試儀收集用力肺活量(FVC）、第一秒用力呼氣容積（FEV1）、尖峰吐氣流速（PEFR）等數值，將身體組成與肺功能的量測數值加以分析比較。 結果:研究結果顯示中風患者體脂肪率明顯偏高，而腰臀比的平均值亦超過國內衛生署所定的肥胖標準。中風時間介於3個月到6個月之間的病患其腰臀比與身體質量指數有下降的趨勢，中風6個月以上的病患其患側邊下肢肌肉的含量比非患側邊的下肢少。中風時間與第一秒用力呼氣量呈現負相關性，中風時間越長者其第一秒用力呼氣量會越差。此外，巴氏量表的分數屬於完全依賴的患者，其用力肺活量平均值明顯低於巴氏量表的分數屬於嚴重依賴、中度依賴、輕度依賴以及完全獨立的患者。在分析中風病患身體組成與肺功能變化方面，發現去脂質量與用力肺活量呈現正相關，腰臀比與體脂肪率則與用力肺活量呈現負相關。 結論:不同時期的中風患者其身體組成與肺功能呈有意義之變化，其結果與相關性可提供醫療團隊作為復健計畫的擬定以及營養與體重控制的參考依據，以期能達到最大的功能性恢復。
並列摘要
Purpose: To investigated the body composition and lung function of stroke patients at different stages. The relation between their lung function and body composition at various levels of disability were also analyzed. Method: 72 stroke patients with age ranges from 37 to 81 years old and the duration of stroke from 5 days to 3 years were recruited. The body composition was evaluated with bioelectrical impedance analyzer, and the lung function included the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR), FEV1 / FVC %, forced expiratory flow between 25% and 75% of forced vital capacity (FEF25-75%) were measured by spirometer. Result: The results revealed that the body fat and average waist-hip ratio were more than the normal range defined by National Health Administration. The stroke patients with duration between 3 months to 6 months had downward trends of waist-hip ratio and BMI. The muscle amount in affected lower limb appeared to be less than the sound side in patients got stroke for more than 6 months. The stroke duration was correlated with the average FEV1 negatively. The longer the duration of stroke, the worse the FEV1 would become. Furthermore, the average FVC was significantly lower in the patients with total-dependent group of Barthel’s index than those with severe-dependent, moderate-dependent, mid-dependent, and total-independent. The positive relationship was found between fat-free mass and FVC, and negative relationship between waist-hip ratio, body fat, and FVC was detected. Conclusion: The significant differences of body composition and lung function were found among the different stages of stroke patients. Which demonstrate that body composition and lung function care are indicated in the design of rehabilitation program for stroke patients.