Zusammenfassung:
In den letzten Jahren ist zunehmend die Erkenntnis gewonnen worden, dass bei COPD viele Faktoren für die beobachtete Unterernährung eine Rolle spielen. Hierbei wurde klar, dass eine komplexe Veränderung des Metabolismus bei COPD-Patienten vorliegt, die durch eine reine Ernährungstherapie wenig zu beeinflussen ist. In dem Übersichtsartikel wird anhand der aktuellen Literatur auf die Malnutrition und den veränderten Metabolismus bei COPD-Patienten eingegangen und die Ernährungsintervention bei diesen Patienten diskutiert.
Unser Blickfeld bezüglich der Therapie muss sich dahin richten, dass wir bei der COPD nicht eine lokale Erkrankung des Bronchialbaumes haben, sondern eher eine systemische Erkrankung, die von der Lunge ausgeht und dort die Hauptsymptome verursacht, aber auch andere Systeme mit einbezieht. Ziel weiterer Studien muss es daher sein, die Muskelfunktion und die Veränderungen in diesem Bereich bei COPD-Patienten noch besser zu verstehen, um dann hierauf Einfluss nehmen zu können. Zukünftige Therapien sollten sich daher nicht nur auf die Behandlung der Inflammation und Dilatation der Bronchien beschränken, sondern darauf ausgerichtet sein, den veränderten Metabolismus bei COPD-Patienten zu beeinflussen, um so die Belastbarkeit der Patienten und vielleicht auch die Prognose zu verbessern.
Malnutrition in COPD:
During the last years our knowledge about the malnutrition of patients with COPD has grown. Weight loss is a problem of some patients with COPD, but, as we know today by techniques of body composition measurement much more patients have reduced muscle mass. The reason for this is complex and involves many body systems. Nutritional intervention alone is not successful in many patients. We have to accept that COPD is a kind of systemic disease which does not only involve the lung. Thus, future therapies have to include not only treatment of the bronchial system.
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PD Dr. J. Bargon
Leiter der Abteilung Pneumologie/Allergologie
St. Elisabethenkrankenhaus
Ginnheimer Straße 3
60487 Frankfurt am Main
eMail: E-mail: bargon@em.uni-frankfurt.de
