社区老年人下肢骨骼肌肌力衰变的趋势和特点  

Trends and characteristics of age-related deterioration of skeleton muscles strength of lower-extremity among community-dwelling older adults

作　　者：焦伟国[1] 周明[1] 彭楠[1] 黎春华[1] 石荣光 方继红 李令臣 李宏伟 李家玉 郭占芳 代强[4] 

机构地区：[1]中国人民解放军总医院南楼康复科,北京100853 [2]总参北极寺干休所 [3]总政干休所 [4]北京大学研究生院

出　　处：《中国康复医学杂志》2013年第5期440-444,共5页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:了解随年龄增长,我国社区老年人下肢肌力状况衰变的趋势和特点,以预防下肢功能衰退和跌倒,提高老年人生存质量。方法:在北京4个社区,采用随机整群抽样方法选取458人作为研究对象,其中50—93岁者412例,对照组20—30岁者46例。用手持式测力计,测量双侧髂腰肌、股四头肌、胫前肌、腘绳肌最大等长肌力。结果:30岁以后,随年龄增长男性和女性下肢肌力均有下降趋势。50岁以上人群各组肌力均随年龄呈持续性下降,从50—85岁的35年间,4组肌力下降约20.82%—44.02%。女性肌力下降比同龄男性明显。不同肌肉下降速率不同,男性肌力下降最明显的是髂腰肌,为5.50kg(31.61%)(P<0.01),女性为胫前肌下降最快,为5.67kg(44.02%)(P<0.01)。65—74岁男性伸膝肌力为(12.90±3.95)kg(左侧),(12.97±3.94)kg(右侧);女性为(9.37±3.09)kg(左侧),(10.11±3.03)kg(右侧)。青年到中年时股四头肌肌力下降36.46%(P<0.001),而中年到老年只下降21.86%(P<0.001)。结论:随年龄增长,男性和女性下肢肌力均呈衰退趋势,老年女性肌力下降比同龄男性快。在青中年时期即应预防股四头肌肌力的衰退。Objective： To observe the characteristics of age-related deterioration of muscle strength of lower-extremity among community-dwelling adults, for the prevention of lower extremity function decline and falls. Method： Using random cluster sampling method, 458 subjects were selected from four communities in Beijing of which 412 subjects aged 50 to 93, 46 cases of 20 to 30 years as controls. Maximal isometric strength was tested by handheld dynamometer to measure bilateral iliopsoas, quadriceps femoris, tibialis anterior, hamstring. Result： After 30 years old, in both men and women muscle strength of lower extremity showed a declining trend with ageing. After 〉50 years old muscle strength declined progressively about 20.82%-44.02% during 35 years. Muscle strength decreased faster in women than that in men at the same age. There were different strength decline rates of different muscles. Iliopsoas had the most obvious strength decrement in mens as 5.Skg （31.61%） （P〈0.01）; tibialis anterior had the fastest strength decline in women, as 5.67kg （44.02%） （P〈0.01）; quadriceps strength declined （12.90 ± 3.95）kg （left）, and （12.97 ± 3.94）kg （right） in 65 to 74-year-old men（9.37 ± 3.09）kg （left）, and （10.11 ±3.03）kg （right in women）. From youth to middle age, quadriceps strength decreased by 36.46% （P〈 0.001）, while from middle-aged to elderly only decreased by 21.86% （P 〈 0.001）. Conclusion： With ageing, muscle strength of lower extremity showed a declining trend both in men and women,strength of older women declined faster than that of men. Quadriceps strength decay should be prevented in young-middle age.

关 键 词：少肌症 老年人 肌力 跌倒 

分 类 号：R685[医药卫生—骨科学]