切换至 "中华医学电子期刊资源库"

中华老年病研究电子杂志 ›› 2021, Vol. 08 ›› Issue (01) : 5 -9. doi: 10.3877/cma.j.issn.2095-8757.2021.01.002

所属专题: 文献

老年综合评估

老年综合评估指导下的老年肌少症综合干预疗效分析
龙囡囡1, 吴玉泉2,(), 徐静2, 韩超2, 曹娟2   
  1. 1. 245000 安徽省黄山职业技术学院;310013 杭州,联勤保障部队第九〇三医院老年病科
    2. 310013 杭州,联勤保障部队第九〇三医院老年病科
  • 收稿日期:2020-09-16 出版日期:2021-02-28
  • 通信作者: 吴玉泉
  • 基金资助:
    浙江省科技计划项目(2015C33179); 安徽省高等学校质量工程项目(2018kfk187); 杭州市医药卫生科技项目(B20200469)

Efficacy of comprehensive intervention for senile sarcopenia under the guidance of comprehensive geriatric assessment

Nannan Long1, Yuquan Wu2,(), Jing Xu2, Chao Han2, Juan Cao2   

  1. 1. Huangshan Vocational and Technical College, Huangshan 245000, China; Department of Geriatrics, 903RD Hospital of PLA Joint Logistic Support Force, Hangzhou 310013, China
    2. Department of Geriatrics, 903RD Hospital of PLA Joint Logistic Support Force, Hangzhou 310013, China
  • Received:2020-09-16 Published:2021-02-28
  • Corresponding author: Yuquan Wu
引用本文:

龙囡囡, 吴玉泉, 徐静, 韩超, 曹娟. 老年综合评估指导下的老年肌少症综合干预疗效分析[J]. 中华老年病研究电子杂志, 2021, 08(01): 5-9.

Nannan Long, Yuquan Wu, Jing Xu, Chao Han, Juan Cao. Efficacy of comprehensive intervention for senile sarcopenia under the guidance of comprehensive geriatric assessment[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2021, 08(01): 5-9.

目的

探讨老年综合评估(comprehensive geriatric assessment, CGA)指导下的综合干预措施对老年肌少症的治疗效果。

方法

采用浙江医院研发的CGA软件进行评估,筛选出2018年6-12月原解放军第一一七医院(现联勤保障部队第九〇三医院)收治的老年肌少症患者120例。其中对照组(60例)患者仅治疗基础疾病,不给予肌少症干预措施;观察组在治疗基础疾病的同时根据CGA结果进行肌少症综合干预,包括运动疗法、营养疗法、药物治疗以及对生活、环境、用药、心理等进行管理。观察两组患者入组时、治疗3个月、治疗6个月的实验室检查(包括血白蛋白、血红蛋白、空腹血糖、胆固醇、甘油三酯以及钠、钾、钙等电解质)结果、人体成分(包括无机盐、蛋白质、体脂肪、BMI以及四肢肌量指数)分析结果和肌少症评估(包括步速、握力及日常生活能力)情况。计量资料的组间比较采用独立样本t检验,计数资料的比较采用χ2检验;两组患者连续性时点指标的比较采用重复测量方差分析。

结果

两组患者白蛋白水平、蛋白质水平、四肢肌量指数及步速的差异均具有组间效应(F=3.783、4.038、61.114、124.119,均P<0.05),治疗3个月和治疗6个月时两组患者白蛋白水平、蛋白质水平、四肢肌量指数及步速的差异均有统计学意义(均P<0.05);其他指标的差异均无组间效应(均P>0.05)。

结论

CGA指导下的综合干预措施对老年肌少症的短期治疗是有效的,长期治疗效果尚有待证实。

Objective

To to explore the therapeutic effect of comprehensive intervention measures under the guidance of comprehensive geriatric assessment (CGA) on senil sarcopenia in the elderly.

Methods

120 elderly patients with sarcopenia who were admitted to No.93 Hospital of the Joint Logistic Support Force from June to December 2018 were evaluated by using CGA software developed by Zhejiang Hospital. The control group (60 cases) was only treated with basic diseases, without sarcopenia intervention measures;The observation group received comprehensive intervention for sarcopenia according to CGA results while treating basic diseases, including exercise therapy, nutrition therapy, drug therapy, and management of life, environment, medication and psychology. Before treatment, 3 months and 6 months after treatment, the results of laboratory examination (including serum albumin, hemoglobin, fasting blood glucose, cholesterol, triglyceride and electrolytes such as sodium, potassium and calcium), body composition (including inorganic salt, protein, body fat, BMI and muscle mass index of extremities) and assessment of sarcopenia (including walking speed, body fat, body fat and muscle mass index of extremities) were observed. T test was used to compare the measurement data between groups, and the χ2 test was used to compare the enumeration data. Repeated measure analysis of variance was used to compare continuous time point indicators between the two groups.

Results

The albumin level, protein level, limb muscle mass index and walking speed in two groups had inter-group effects (F=3.783, 4.038, 61.114, 124.119, P < 0.05), and there were statistically significant differences in albumin level, protein level, limb muscle mass index and walking speed between two groups after 3 months and 6 months of treatment (P < 0.05). There was no inter-group effect in other indicators (P > 0.05).

Conclusion

Comprehensive intervention measures under the guidance of CGA are effective in the short-term treatment of senile sarcopenia, but the long-term treatment effect remains to be confirmed.

表1 两组患者治疗前后实验室检查指标的比较(±s
表2 两组患者治疗前后人体成分分析结果的比较
表3 两组患者治疗前后步速、握力及日常生活能力评分的比较
[1]
Liu P, Hao Q, Hai S, et al. Sarcopenia as a predictor of allcau-se mortality among community-dwelling older people: A systematic review and meta-analysis[J]. Maturitas, 2017, 103:16-22.
[2]
Romero-Ortuno R, Kenny RA. The frailty index in Europeans: Associstion with age and mortality[J]. Age Ageing, 2012, 41(5):684-689.
[3]
Collard RM, Boter H, Schoevers RA, et al. Prevalence of frailty in community-dwelling older persons: A systematic review[J]. J Am Geriatr Soc, 2012, 60(8):1487-1492.
[4]
Cheng Q, Zhu X, Zhang X, et al. A cross-sectional study of loss of muscle mass corresponding to sarcopenia in healthy Chinese men and women: Reference values, prevalence, and association with bone mass[J]. J Bone Miner Metab, 2014, 32(1):78-88.
[5]
范利.老年肌少症和衰弱综合征之间的关系[J].中华保健医学杂志,2014,16(6):415-416.
[6]
陈恒亭,马信龙,马剑雄,等.肌肉减少症运动疗法[J].中华骨质疏松和骨矿盐疾病杂志,2017,10(6):582-588.
[7]
金鑫,马晓妍,张静,等.综合干预对肌少症患者生活质量及预后的影响研究[J].中国现代医学杂志,2016,26(23):99-103.
[8]
Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia:Consensus report of the Asia Working Group for Sarcopenia[J]. J Am Med Dir Assoc, 2014, 15(2):95-101.
[9]
吴永华,杨丽君,张俐.老年衰弱、肌少症与营养[J]. 实用老年医学,2017,31(4):403-407.
[10]
Scott D, Hayes A, Sanders KM, et al. Operational definitions of sarcopenia and their associations with 5-year changes in falls risk in community-dwelling middle-aged and older adults[J]. Osteoporos Int, 2014, 25(1):187-193.
[11]
Jarvinen TL, Sievanen H, Khan KM, et al. Shifting the focus in fracture prevention from osteoporosis to falls[J]. BMJ, 2008, 336(7636):124-126.
[12]
龙囡囡,吴玉泉.肌少症的认识及其研究进展[J].中华保健医学杂志,2018,20(5):447-450.
[13]
Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment[J]. JAMDA, 2020, 21(3):300-307.
[1] 李凤仪, 李若凡, 高旭, 张超凡. 目标导向液体干预对老年胃肠道肿瘤患者术后血流动力学、胃肠功能恢复的影响[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 29-32.
[2] 晏晴艳, 雍晓梅, 罗洪, 杜敏. 成都地区老年转移性乳腺癌的预后及生存因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 636-638.
[3] 李婷婷, 吴荷玉, 张悦, 程康, 张晓芳, 程娅婵. 复合保温策略在老年腹腔镜解剖性肝切除术中的应用研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 522-525.
[4] 刘跃刚, 薛振峰. 腹腔镜腹股沟疝日间手术在老年患者中的安全性分析[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 711-714.
[5] 代格格, 杨丽, 胡媛媛, 周文婷. 手术室综合干预在老年腹股沟疝患者中的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 759-763.
[6] 赵宏霞, 刘静, 李晓薇, 陈金婵, 汪志霞. 腹腔镜下经阴道子宫全切术联合阴道前后壁修补术治疗老年子宫脱垂效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 561-565.
[7] 孙伟, 林丽, 师高洋. 超声引导下连续髂腹股沟-髂腹下神经阻滞与腹横肌平面阻滞在老年腹股沟疝手术中应用效果比较[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 593-597.
[8] 张汪, 徐淑英, 张爱华, 夏芬荣, 汪露. 手术室体温护理结合细节护理干预在老年腹股沟疝围手术期的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 635-638.
[9] 王宁, 刘彦哲, 吴紫莺, 曾超, 雷光华, 沙婷婷, 王伊伦. 基于孟德尔随机化研究探讨肠道菌群与肌少症表型的因果关联[J]. 中华老年骨科与康复电子杂志, 2023, 09(06): 333-342.
[10] 杨鹏, 刘冲. PFNA治疗老年股骨转子间骨折后隐匿性失血及其危险因素的横断面研究[J]. 中华老年骨科与康复电子杂志, 2023, 09(05): 301-306.
[11] 姜里蛟, 张峰, 周玉萍. 多学科诊疗模式救治老年急性非静脉曲张性上消化道大出血患者的临床观察[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 520-524.
[12] 单秋洁, 孙立柱, 徐宜全, 王之霞, 徐妍, 马浩, 刘田田. 中老年食管癌患者调强放射治疗期间放射性肺损伤风险模型构建及应用[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 388-393.
[13] 毛树文, 袁方, 唐昊, 王建民. 针刀调节交感神经对老年胃溃疡患者胃功能和溃疡愈合的影响[J]. 中华消化病与影像杂志(电子版), 2023, 13(05): 326-330.
[14] 郭震天, 张宗明, 赵月, 刘立民, 张翀, 刘卓, 齐晖, 田坤. 机器学习算法预测老年急性胆囊炎术后住院时间探索[J]. 中华临床医师杂志(电子版), 2023, 17(9): 955-961.
[15] 王家圆, 王晓东. 消化系统恶性肿瘤相关肌少症的研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(07): 823-827.
阅读次数
全文


摘要