摘要
目的观察肌少症对脑梗死患者神经功能缺损和生活能力的影响及相关危险因素。方法选取2017年1月至2019年1月在山西白求恩医院全科医学科住院治疗的急性脑梗死合并肌少症患者70例为观察组,另外选取同期年龄、性别均与观察组相匹配的非肌少症的急性脑梗死患者70例为对照组。比较两组患者入院时一般临床资料(如吸烟史、饮酒史、生化指标、合并疾病情况、营养情况等)、去脂体重指数(FFMI)、美国国立卫生研究院卒中量表(NIHSS)评分(用于评估神经功能缺损程度)、日常生活能力(ADL)评分,并比较两组患者出院3个月后NIHSS、ADL评分及脑卒中影响量表(SIS)评分(用于评估社会回归能力)。对肌少症可能存在的影响因素进行logistic回归分析。结果入院时,观察组患者FFMI[(17.70±0.36)比(17.90±0.26)kg/m2,t=3.751]及NIHSS[(15.00±3.51)比(12.17±3.21)分,t=-4.947]、ADL评分[(28.64±6.70)比(37.14±6.68)分,t=7.518]均较对照组低(均P<0.05)。两组患者出院3个月后与入院时比较,NIHSS、ADL评分均有好转,但观察组患者NIHSS[(-1.99±1.17)比(-3.93±1.47)分,t=8.651,P<0.05]、ADL[(6.64±4.32)比(15.50±5.05)分,t=-11.158,P<0.05]恢复幅度较对照组低;而且观察组患者SIS评分较对照组低[(64.59±5.48)比(74.51±4.58)分,t=-11.639,P<0.05]。多因素logistic回归显示,体重下降(OR=5.094)、骨质疏松(OR=2.856)、激素水平异常(OR=1.885)及合并疾病>3种(OR=2.045)均为脑梗死患者合并肌少症的危险因素(均P<0.05)。结论合并肌少症的急性脑梗死患者神经功能缺损严重、日常生活能力下降明显,且恢复期神经功能缺损、日常生活能力改善情况及社会回归能力均低于未合并肌少症的脑梗死患者。体重下降、骨质疏松、激素水平异常及合并疾病>3种均为脑梗死患者合并肌少症的危险因素。
Objective To investigate the effects of sarcopenia on neurological function and quality of life in patients with cerebral infarction and its risk factors.Methods Seventy acute cerebral infarction patients with sarcopenia(study group)and 70 age and gender-matched acute cerebral infarction patients without sarcopenia(control group)admitted in Shanxi Bethune Hospital from January 2017 to January 2019 were enrolled in the study.The fat free mass index(FFMI),National Institute of Health Stroke Scale(NIHSS),activity of daily living(ADL)and other related indexes were assessed at the admission and compared between the two groups.Three months after discharge,the neurological impairment,improvement of daily living ability and social regression ability were compared between two groups.Logistic regression analysis was conducted for the risk factors of sarcopenia.Results The FFMI[(17.70±0.36)vs.(17.90±0.26)kg/m2,t=3.751,P<0.05],NIHSS9[(15.00±3.51)vs.(12.17±3.21),t=-4.947,P<0.05]and ADL scores[(28.64±6.70)vs.(37.14±6.68),t=7.518,P<0.05]of the study group were lower than those of the control group at the admission.NIHSS and ADL scores of the two groups were improved three months after discharge.However,the degree of improvement in NIHSS and ADL of the study group was lower than that of the control group[(-1.99±1.17)vs.(-3.93±1.47),t=8.651,P<0.05;(6.64±4.32)vs.(15.50±5.05),t=-11.158,P<0.05,respectively].Meanwhile,the social regression score(SIS)of the study group was lower than that of the control group[(64.59±5.48)vs.(74.51±4.58),t=-11.639,P<0.05].Multivariate logistic regression showed that weight loss(OR=5.094),osteoporosis(OR=2.856),abnormal hormone levels(OR=1.885)and comorbid diseases>3(OR=2.045)were risk factors of sarcopenia(all P<0.05).Conclusion Acute cerebral infarction patients with sarcopenia have severe neurological function impairments and decreased activities of daily living.Weight loss,osteoporosis,abnormal hormone levels,and comorbid diseases>3 are risk factors for sarcopenia in cerebral infarction patients.
作者
王建华
冯玫
乔爱春
何志强
李丽琪
王晓旭
Wang Jianhua;Feng Mei;Qiao Aichun;He Zhiqiang;Li Liqi;Wang Xiaoxu(Department of General Practice,Shanxi Bethune Hospital,Taiyuan 030021,China)
出处
《中华全科医师杂志》
2020年第9期824-828,共5页
Chinese Journal of General Practitioners
关键词
脑梗死
肌少症
危险因素
神经功能缺损
日常生活能力
Cerebral infarction
Sarcopenia
Risk factor
Neurological impairment
Ability of daily living
作者简介
通信作者:冯玫山,Email:1747003708@qq.com。
