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中华老年病研究电子杂志 ›› 2019, Vol. 06 ›› Issue (04) : 23 -26. doi: 10.3877/cma.j.issn.2095-8757.2019.04.005

所属专题: 文献

临床研究

老年衰弱综合征与肌少症的相关性
张艳汝,1, 刘婷婷1, 刘晖1, 李继红1   
  1. 1. 830001 乌鲁木齐,新疆维吾尔自治区人民医院干部保健中心
  • 收稿日期:2019-03-25 出版日期:2019-11-28
  • 通信作者: 张艳汝

Relationship between asthenia syndrome and sarcopenia in the elderly

Yanru Zhang,1, Tingting Liu1, Hui Liu1, Jihong Li1   

  1. 1. Cadre Health Center, Xinjiang Uygur Autonomous Region people's Hospital, Urumqi 830001, China
  • Received:2019-03-25 Published:2019-11-28
  • Corresponding author: Yanru Zhang
  • About author:
    Corresponding authors: Zhang Yanru, Email:
引用本文:

张艳汝, 刘婷婷, 刘晖, 李继红. 老年衰弱综合征与肌少症的相关性[J/OL]. 中华老年病研究电子杂志, 2019, 06(04): 23-26.

Yanru Zhang, Tingting Liu, Hui Liu, Jihong Li. Relationship between asthenia syndrome and sarcopenia in the elderly[J/OL]. Chinese Journal of Geriatrics Research(Electronic Edition), 2019, 06(04): 23-26.

目的

探讨老年衰弱综合征与肌少症的关系。

方法

选取2017年9月至2018年3月在新疆维吾尔自治区人民院体检资料完整的134例老年人,根据有无衰弱及衰弱程度分为无衰弱组(29例)、衰弱前期组(87例)、衰弱组(18例)。衰弱综合征采用美国Fried五项标准判断,肌少症根据肌力(握力测定)、肌功能(日常步行速度测定)、起立-行走测试、5次起坐测试以及平衡试验进行评估。多组间计量资料的比较采用方差分析,计数资料的比较采用秩和检验,衰弱程度与肌肉指标的相关性采用Pearson相关分析。

结果

3组老年人年龄、体重减轻、生活活动能力下降、平衡和步态、跌倒风险、营养不良、精神心理、多重用药、睡眠障碍、听力下降、缺牙数目、尿失禁、压疮以及衰弱评分的差异均有统计学意义(均P<0.01),但无衰弱组和衰弱前期组老年人营养不良、压疮、跌倒风险及缺牙数目的差异均无统计学意义(均P>0.05)。3组老年人握力、步速、四肢骨骼肌质量、5次起坐测试验、平衡试验以及起立行走试验的差异有统计学意义(F=3 101.631、66.308、598.000,χ2=14.808、19.972、25.343;均P<0.01)。相关性分析结果显示,衰弱程度得分与握力、步速及四肢骨骼肌质量评分均呈负相关(r=-0.152、-0.500、-0.358,P<0.05或0.01)。

结论

肌少症是衰弱发生的重要原因,肌肉相关指标的变化可能是衰弱综合征发展的重要指征。

Objective

To explore the relationship between sarcopenia and asthenia syndrome in the elderly.

Methods

134 elderly people, who had complete physical examination information admitted in Xinjiang Uygur Autonomous Region People's Hospital from September 2017 to March 2018 were selected. Clinical data were collected for evaluation. Asthenia syndrome was estimated by American Fried 5 criterions, sarcopenia was estimated by myodynamia (grip strength measurement), muscle function (daily walking speed measurement), standing walk measurement, 5 sit up tests and balance test. Analysis of variance was used to compare measurement data between groups. The count data was compared using Kruskal-Wallis test. The correlation between degree of asthenia and muscle indicators was analyzed by Pearson correlation analysis.

Results

The differences of age, weight loss, decline in living activity, balance and gait, the risk of falling, malnutrition, mental psychology, multiple medication, sleep disorder, hearing loss, number of teeth missing, urinary incontinence, pressure sore and asthenia score among 3 groups were statistically significant (all P < 0.01). There were no statistical significance differences in malnutrition, pressure sore, the risk of falling and number of teeth missing between no asthenia group and early asthenia group (all P > 0.05). The differences of grip, step speed, skeletal muscle quality of all fours,5 sit up tests , balance test and standing walk measurement among 3 groups were statistically significant (F=3 101.631, 66.308, 598.000, χ2=14.808, 19.972, 25.343, all P < 0.01). Correlation analysis results showed that the score of degree of asthenia and grip, step speed and score of skeletal muscle quality of all fours were all negatively correlated (r=-0.152, -0.500, -0.358, P < 0.05 or 0.01).

Conclusion

Sarcopenia is the main cause of asthenia syndrome. The change of muscle related indexes may be an important indication in the development of asthenia syndrome.

表1 3组老年人衰弱具体表现分布情况[例(%)]
表2 3组老年人一般情况的比较
指标 无衰弱(n=29) 衰弱前期(n=87) 衰弱期(n=18) 检验值 P
年龄(岁) 75.2±4.2 77.8±5.4 86.7±3.8 F=4403.521 <0.01
性别(男/女,例) 20/9 65/22 13/5 χ2=0.120 >0.05
民族(汉/维/哈,例) 15/11/3 37/31/19 9/7/2 χ2=0.149 >0.05
体重减轻[例(%)] 1(3.5) 8(9.2) 10(52.6) χ2=19.728 <0.01
吸烟[例(%)] 18(62.1) 65(74.7) 10(55.6) χ2=3.523 >0.05
饮酒[例(%)] 25(86.2) 76(87.4) 14(77.8) χ2=0.426 >0.05
生活活动能力下降[例(%)] 1(3.5) 4(4.6) 5(27.8) χ2=7.249 <0.01
平衡和步态(分) 15.4±1.3 14.8±1.6 10.4±1.3 F=1006.300 <0.01
跌倒风险(分) 19.8±1.8 19.8±1.9 20.2±1.5 F=8.010 <0.01
营养不良(分) 13.1±1.1 12.8±1.4 10.3±1.2 F=397.744 <0.01
精神心理(分) 29.1±0.8 28.6±1.0 24.3±2.6 F=3030.811 <0.01
慢性疼痛[例(%)] 14(44.8) 50(51.7) 8(44.4) χ2=1.458 >0.05
共病种数 3.9±0.8 3.7±0.9 4.3±1.1 F=3.607 >0.05
多重用药[例(%)] 17(58.6) 79(90.8) 15(83.3) χ2=7.659 <0.01
睡眠障碍(分) 1.7±0.8 2.4±0.8 4.5±1.0 F=376.625 <0.01
视力下降[例(%)] 23(79.3) 70(80.5) 14(77.8) χ2=0.010 >0.05
听力下降[例(%)] 6(20.7) 15(17.2) 9(50.0) χ2=3.700 >0.05
缺牙数目(颗) 18.1±6.2 17.7±7.0 19.8±6.8 F=8.191 <0.01
尿失禁[例(%)] 1(3.5) 8(10.3) 11(61.1) χ2=13.460 <0.01
压疮(分) 20.0±1.4 20.0±1.6 19.6±2.1 F=12.982 <0.01
衰弱评分(分) 0 2.1±0.8 4.6±0.5 F=657.215 <0.01
表3 不同衰弱程度老年人肌肉功能指标的比较
[1]
Rizzoli R, Reginsterb J-Y, Arnal J-F, et a1. Quality of Life in sarcopenia and frailty[J].Calcif Tissue Int, 2013, 93(2):101-120.
[2]
Landi F, Calvani R, Cesari M, et a1. Sarcopenia asthe biological substrate of physical frailty[J]. Clin Geriatr Med, 2015, 31(3):367-374.
[3]
Rosenberg IH. Summary comments[J]. Am J Clin Nutr, 1989, 50(5):1231-1233.
[4]
Baumgartner RN, Koehler KM, Gallagher D, et al. Epidemiology of sarcopenia among the elderly in New Mexico[J]. Am J Epidemiol, 1998, 147(8):755-763.
[5]
Martinez-Gomez D, Bandinelli S, Del-Panta V, et al. Three-year changes in physical activity and decline in physical performance over 9 years of follow-up in older adults: the invecchiare in Chianti study[J]. J Am Geriatr Soc, 2017, 65(6):1176-1182.
[6]
Fried LP, Tangen CM, Walston J, et a1. Frailty in older adults: evidence for a phenotype[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(3):146-156.
[7]
王秋梅,陈亮恭.肌少症的亚洲诊断共识:未来的发展与挑战[J].中华老年医学杂志,2015,34(5):461-462.
[8]
Shen S, He T, Chu J, et al. Uncontrolled hypertension and orthostatic hypotension in relation to standing balance in elderly hypertensive patients[J].Clin Interv Aging, 2015, 28(5):897-906.
[9]
Chu JJ, Chen XJ, Shen SS, et al. A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension: a cross-sectional study[J]. J Geriatr Cardiol, 2015, 12(2):113-118.
[10]
Rubenstein LZ, Harker JO, SalvàA, et al. Screening for undernutrition in geriatric practice: developing the short-form mininutritional assessment (MNA-SF)[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(6):M366-M372.
[11]
Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician[J]. J Psychiatr Res, 1975, 12(3):189-198.
[12]
Rapo-PylkköS, HaanpääM, Liira H. Subjective easiness of pain assessment measures in older people[J]. Arch Gerontol Geriatr, 2016, 65:25-28.
[13]
Kim KW, Kang SH, Yoon IY, et al. Prevalence and clinical characteristics of insomnia and its subtypes in the Korean elderly[J].Arch Gerontol Geriatr, 2017, 68:68-75.
[14]
张耀光,魏东,王建业,等.经闭孔无张力尿道吊带术治疗女性压力性尿失禁的疗效与安全性分析[J].中华泌尿外科杂志,2012,33(9):672-674.
[15]
姜丽萍,张龙,陈丽莉.应用Braden量表联合近红外光谱仪评估ICU患者压疮发生的研究[J].中华护理杂志,2014,49(8):901-904.
[16]
Cruz-Jentoft AJ, Baeyens JP, Bauer J, et a1. Sarcopenia:European consensus on definition and diagnosis:report of the European Working Group onsarcopenia in older people[J]. Age Ageing, 2010, 39(4):412-423.
[17]
Nishiguchi S, Yamada M, Fukutani N, et a1. Differential association of frailty with cognitive decline and sarcopenia in community-dewelling older adults[J]. J Am Med Dir Assoc, 2015, 16(2):120-124.
[18]
Mijnarends DM, Sehols JM, Meijers JM, et a1. Instruments to assess sarcopenia and physical frailty in older people living in a community(care)setting: similarities and discrepancies[J]. J Am Med Dir Assoc, 2015, 16(4):301-308.
[19]
Cesari M, Landi F, Velias B, et a1. Sarcopenia and physical frailty: two sides of the same coin[J]. Front Aging Neurosci, 2014, 6:192.
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