双能X线吸收测量法评价减重手术对身体成分的短期影响  

Short-Term Effects of Bariatric Surgery on Body Composition Assessed by Dual-Energy X-Ray Absorptiometry

作　　者：孙鹤[1] 孙玲玲[1] 潘诗农[2] 李林孺 李琦 王磊 王勇[4] SUN He;SUN Lingling;PAN Shinong;LI Linru;LI Qi;WANG Lei;WANG Yong(Department of Radiology,The Fourth Affiliated Hospital,China Medical University,Shenyang 1100,China;Department of Radiology,ShengjingHospital,China Medical University,Shenyang 11000,China;Department of Medical Imaging,Liaoning Electric Power Center Hospital,Shenyang110006,China;Department of Metabolic Srugery,The Fourth Affiliated Hospital,China Medical University,Shenyang 1100,China)

机构地区：[1]中国医科大学附属第四医院放射科,沈阳110032 [2]中国医科大学附属盛京医院放射科,沈阳110004 [3]辽宁电力中心医院医学影像科,沈阳110006 [4]中国医科大学附属第四医院代谢外科,沈阳110032

出　　处：《中国医科大学学报》2019年第3期260-264,共5页Journal of China Medical University

摘　　要：目的探讨肥胖患者减重术后短期身体成分的变化情况。方法选取行减重手术的57例患者,于术前及术后1、3个月采用DEXA检查方法测量全身及不同区域的身体成分指标,并对这些指标的差异性进行比较。结果体质量指数(BMI)、肌肉含量(LM)于术后1、3个月分别下降10.61%及18.51%、13.22%及14.35%,而A/G脂肪含量(FM)仅于术后3个月出现了明显下降(P <0.05);术后1、3个月时脊柱骨矿物质密度(BMD)增加、骨盆BMD减少,而全身BMD分别减少了1.23%及1.45%(P <0.05);脊柱、骨盆及全身骨矿物质含量(BMC)在术后1、3个月均较基线时增加,结果有统计学差异(P <0.05);术后2次随访全身FM分别减少了9.52%及22.77%,有4个区域(下肢、躯干、A区及G区)出现减少,其中以A区减少程度最大,分别为15.80%及31.86%,有统计学差异(P <0.05)。结论减重手术可以在短期内有效降低患者BMI及FM,促进脂肪的重新分布,但同时伴随全身LM的减少,而骨盆及全身BMD和BMC的变化趋势相反。Objective To assess the short-term effects of bariatric surgery on body composition. Methods Fifty-seven patients who underwent bariatric surgery were assessed by dual-energy x-ray absorptiometry( DEXA) before surgery,and 1 and 3 months after surgery. The body composition indexes of whole body and different regions were compared. Results The body mass index( BMI) decreased by 10.61% and 18.51%,and the lean mass( LM) by 13.22% and 14.35% at 1 and 3 months after surgery,respectively. The A/G far mass( FM) decreased significantly 3 months after surgery( P < 0.05). The bone mineral density( BMD) of the spine increased,but that of the pelvis decreased at 1 and 3 months after the operation, and a reduction was observed in the BMD of the whole body by 1.23% and 1.45%,respectively( P < 0.05). Compared to the baseline,the bone mineral conten(t BMC) of the spine,pelvis,and whole body increased at 1 and 3 months post-surgery,with a statistically significant difference (P < 0.05). The FM of the whole body( 9.52% and 22.77%) and four regions( legs,trunk,android,and gynoid) reduced. A significant loss of FM( P < 0.05) was observed in the android region by 15.80% and 31.86% at the two follow-ups. Conclusion Bariatric surgery can effectively reduce the patient’s BMI and FM in the short term,and promotes the redistribution of fat;however,it may be accompanied by a reduction in LM,while the BMD and BMC change trend of pelvis and whole body are opposite.

关 键 词：肥胖 减重手术 双能X线吸收测量法 身体成分 

分 类 号：R445.4[医药卫生—影像医学与核医学]