肌少症对老年慢性心力衰竭患者肌力和活动能力的影响  

Impact of sarcopenia on muscle strength and exercise capacity in elderly patients with chronic heart failure

作　　者：肖潇 胡松[1] 赵婷[2] 刘佳[1] 安妮娜[1] 毛拥军[1] Xiao Xiao;Hu Song;Zhao Ting;Liu Jia;An Nina;Mao Yongjun(Department of Geriatrics,the Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Nutrition,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院老年医学科,266003 [2]青岛大学附属医院营养科,266003

出　　处：《中华全科医师杂志》2019年第4期343-346,共4页Chinese Journal of General Practitioners

基　　金：国家自然科学基金面上项目(31571829).

摘　　要：目的探讨肌少症对老年慢性心力衰竭(CHF)患者肌力和活动能力的影响。方法纳入2017年5月至2018年5月于山东省某三甲医院老年医学科住院的患者116例。记录患者一般临床资料,采用人体成分分析仪测定四肢骨骼肌量(ASM),同时测量肌力、完成6m步行试验。根据亚洲肌少症工作组(AWGS)的诊断标准将研究对象分为肌少症组和非肌少症组。采用回归分析老年CHF住院患者肌少症与其肌力和活动能力下降的相关性。结果老年CHF住院患者肌少症的发生率为36.2%(42/116)。与非肌少症组相比,肌少症组患者的心功能较差[纽约心脏病协会分级(2.4±0.5)级],肌力[(21.0±5.4)kg]、ASM[(19.8±3.3)kg]及6m步行速度[(0.7±0.2)m/s]均较低(均P<0.05)。简单回归分析示两组患者ASM与肌力均呈正相关关系(均r>0.8,P<0.01)。logistic回归分析示校正混杂因素后,ASM减少是活动能力下降的独立危险因素(校正后OR=0.158,95%CI:0.055~0.455,P<0.05)。结论肌少症是老年CHF患者的常见合并症,且可能导致其肌力和活动能力降低。Objective To investigate the impact of sarcopenia on muscle strength and exercise capacity in elderly patients with chronic heart failure(CHF).Methods One hundred and sixteen inpatient aged≥65 years with CHF were enrolled in the study.General clinical characteristics were collected with questionnaire;the appendicular skeletal muscle mass(ASM)was assessed with body composition analyzer;the arm muscle strength was measured and a 6m-walk test was performed.The sarcopenia was evaluated according to the Asian Working Group for Sarcopenia(AWGS)criteria.Simple regression analysis and logistic regression were used to analyze the correlation between sarcopenia and decreased muscle strength,exercise capacity in elderly CHF patients.Results Among 116 elderly CHF patients,sarcopenia was confirmed in 42 patients(36.2%).Patients with sarcopenia had poorer cardiac function and lower muscle strength,ASM and 6m-walking speed than patients without sarcopenia did(allP<0.05).Simple regression analysis showed positive correlation between ASM and muscle strength in both groups.Logistic regression analysis showed that after adjustment for confounders,ASM reduction was an independent risk factor for reducedexercisecapacity(OR=0.158,95%CI:0.055-0.455,P<0.05).Conclusion Sarcopenia is a common complication in elderly patients with CHF and may lead to decreased muscle strength and exercise capacity.

关 键 词：老年人 慢性心力衰竭 肌少症 活动能力 

分 类 号：R541.6[医药卫生—心血管疾病]