补充乳清蛋白对合并糖尿病的脑卒中相关肌少症患者的影响  

Effect of whey protein supplementation on stroke-related sarcopenia in patients with diabetes mellitus

作　　者：苏丽丽 方小养 林玲[1] 李海燕[1] SU Lili;FANG Xiaoyang;LIN Ling;LI Haiyan(Department of Rehabilitation,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州医科大学附属第一医院康复科,浙江温州325000

出　　处：《中国现代医生》2024年第22期27-31,共5页China Modern Doctor

基　　金：浙江省温州市科学技术局基础性医疗卫生科技项目(Y2020311)。

摘　　要：目的探讨补充乳清蛋白对合并糖尿病的脑卒中相关肌少症患者康复疗效的影响。方法选取2021年1月至2023年9月于温州医科大学附属第一医院住院的合并糖尿病的脑卒中相关肌少症患者47例,根据随机数字表法将其分为观察组(24例)和对照组(23例)。两组患者均给予正常糖尿病饮食、常规药物治疗和康复训练,观察组患者在此基础上每日口服乳清蛋白粉,共4周。比较两组患者干预前后非偏瘫侧手握力、四肢骨骼肌质量指数(appendicular skeletal muscle mass index,ASMI)、改良Barthel指数(modified Barthel index,MBI)、Fugl-Meyer评定量表(Fugl-Meyer assessment,FMA)、微型营养评定简表(mini-nutritional assessment short-form,MNA-SF)、血清白蛋白(albumin,Alb)、C反应蛋白(C-reactive protein,CRP)。结果干预后,两组患者的握力、ASMI、FMA、MBI均显著高于本组干预前,CRP水平显著低于本组干预前(P<0.05),且观察组患者的握力、ASMI、FMA、MBI、MNA-SF评分及Alb均显著高于对照组,CRP显著低于对照组(P<0.05);患者的ASMI与Alb、MNA-SF评分、握力均呈正相关(P<0.05),CRP与Alb、MNA-SF评分、ASMI均呈负相关(P<0.05)。结论补充乳清蛋白可改善合并糖尿病的脑卒中相关肌少症患者的营养状况、肌力及肌量,提高患者躯体运动功能及日常生活活动能力。Objective To investigate the effect of whey protein supplementation on rehabilitation of stroke-related sarcopenia patients with diabetes mellitus.Methods Forty-seven stroke-related sarcopenia patients with diabetes mellitus admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2021 to September 2023 were selected and divided into observation group(24 cases)and control group(23 cases)according to random number table method.Patients in both groups were given normal diabetic diet,conventional drug therapy and rehabilitation training,and patients in observation group were given whey protein powder orally every day for 4 weeks.The non-hemiplegic hand grip strength,appendicular skeletal muscle mass index(ASMI),modified Barthel index(MBI),Fugl-Meyer assessment(FMA),mini-nutritional assessment short-form(MNA-SF),serum albumin(Alb),C-reactive protein(CRP)were compared between two groups before and after intervention.Results After intervention,the grip strength,ASMI,FMA,MBI of two groups were significantly higher than before ntervention,and CRP level was significantly lower than before intervention(P<0.05).The grip strength,ASMI,FMA,MBI,MNA-SF score and Alb of observation group were significantly higher than those of control group,while CRP was significantly lower than that of control group(P<0.05).ASMI was positively correlated with Alb,MNA-SF score and grip strength(P<0.05),while CRP was negatively correlated with Alb,MNA-SF score and ASMI(P<0.05).Conclusion Supplementation of whey protein can improve the nutritional status,muscle strength and muscle mass of patients with stroke-related sarcopenia complicated with diabetes mellitus,and improve the physical motor function and the ability of daily living.

关 键 词：肌少症 乳清蛋白 营养干预 脑卒中 糖尿病 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R685[医药卫生—临床医学]