衰弱和脑梗死患者肌少症的关系研究

doi:10.3969/j.issn.1006-6233.2021.04.028

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摘要 目的: 探讨衰弱和脑梗死患者肌少症的关系。方法: 选择80例脑梗死患者作为研究对象,根据衰弱指数(FI)将患者分为无衰弱组(<0.12)、衰弱前期组(0.12~0.25)及衰弱组(0.25)。详细记录患者的基本信息、握力及6m步行时间等,采用生物电阻抗法测量四肢及全身骨骼肌量。分析影响脑梗死患者衰弱发生的危险因素,分析衰弱程度与脑梗死患者肌肉症的相关性。结果: 80例脑梗死患者中有14例提示存在衰弱,占17.5%,28例为衰弱前期,占35.0%,38例无衰弱,占47.5%。衰弱组年龄≥60岁、合并糖尿病、最高NIHSS评分≥16分及肌少症比例高于衰弱前期组与无衰弱组(P<0.05),衰弱前期组年龄≥60岁、合并糖尿病、最高NIHSS评分≥16分及肌少症比例高于无衰弱组(P<0.05)。衰弱组小腿围、四肢及全身骨骼肌量、握力均低于衰弱前期组与无衰弱组(P<0.05),6m步行时间长于衰弱前期组与无衰弱组(P<0.05);衰弱前期组握力低于无衰弱组(P<0.05),6m步行时间长于无衰弱组(P<0.05)。多因素分析发现:肌少症、四肢骨骼肌量少、握力降低及6m步行时间延长是脑梗死患者发生衰弱的危险因素(P<0.05)。相关性分析发现:衰弱指数FI与四肢骨骼肌量和握力呈负相关关系(P<0.05);与6m步行时间呈正相关关系(P<0.05)。结论: 脑梗死患者衰弱与肌少症存在正相关关系,高龄、NIHSS评分高、糖尿病、肌少症、四肢骨骼肌量少、握力降低及6m步行时间延长可以促进脑梗死患者出现衰弱。

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	张雷
	张小明

关键词 ：脑梗死, 衰弱, 骨骼肌量, 肌少症, 握力

Abstract：Objective: To study the relationship between asthenia and sarcopenia in patients with cerebral infarction.Methods: Eighty patients with cerebral infarction were selected as the research objects. According to the frailness index (FI), the patients were divided into non-frailness group (< 0.12), pre-frailness group (0.12–0.25) and frailness group (0.25). The patients' basic information, grip strength and 6m walk time were recorded in detail, and the body and limb skeletal muscle mass was measured by bioelectrical impedance spectroscopy. Multivariate logistic regression was used to analyze the risk factors for the occurrence of asthenia in patients with cerebral infarction, and Spearman's correlation was used to analyze the correlation between the degree of asthenia and muscular dystrophy in patients with cerebral infarction. Results: In 80 patients with cerebral infarction, 14 cases (17.5%) were suggested to be of frailty, 28 cases (35.0%) were in pre-frailty state, and 38 cases (47.5%) were not of frailty. The proportion of patients with age ≥60 years old, diabetes mellitus combined, highest NIHSS score ≥16 and myopathy in the frailty group was higher than that in the pre-frailty group and non-frailty group (P<0.05). The proportion of patients with age ≥60 years old, diabetes mellitus combined, highest NIHSS score ≥16 and myopathy in the pre-frailty group was higher than that in the non-frailty group (P<0.05). The circumference of lower leg, the volume of limbs and whole body skeletal muscle, and the grip strength in the frailty group were lower than those in the pre-frailty group and the non-frailty group (P<0.05), and the 6m walking time was longer than that in the pre-frailty group and the non-frailty group (P<0.05). The grip strength in the pre-frailty group was lower than that in the non-frailty group (P<0.05), and the 6m walking time was longer than that in the non-frailty group (P<0.05). Multivariate analysis found that sarcopenia, less skeletal muscle mass of the limbs, decreased grip strength and prolonged 6m walking time were risk factors for debilitating patients with cerebral infarction (P<0.05). Correlation analysis found that the frailty index FI was negatively correlated with limb skeletal muscle mass and grip strength (P<0.05); it was positively correlated with 6m walking time (P<0.05). Conclusion: There is a positive correlation between the frailness and sarcopenia in patients with cerebral infarction. The frailness in patients with cerebral infarction can be promoted by advanced age, high NIHSS score, diabetes, sarcopenia, small amount of skeletal muscle in four limbs, reduced grip strength and 6m walk time.

Key words： Cerebral infarction Frailty Skeletal muscle mass Sarcopenia Grip

基金资助:安徽省自然科学基金项目,(编号:LMPT201706)

通讯作者: 张小明

引用本文:

张雷, 张小明. 衰弱和脑梗死患者肌少症的关系研究[J]. 河北医学, 2021, 27(4): 659-664.
ZHANG Lei, ZHANG Xiaoming. A Study on the Relationship Between Asthenia and Myopathy in Patients with Cerebral Infarction. HeBei Med, 2021, 27(4): 659-664.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.04.028 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I4/659

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