本文選題：肌肉減少癥　切入點：住院老年人　出處：《重慶醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：在本研究中,我們使用兩種不同肌肉減少癥(Sarcopenia)工作組推薦的診斷切割點來評估住院老年人肌肉減少的患病率,并分析了肌肉減少與一些潛在危險因素的相關(guān)性。方法：本研究納入了重慶醫(yī)科大學(xué)附屬第一醫(yī)院接受過DXA檢查的694名住院老年人(男324、女370)。EWGSOP推薦使用肌肉指數(shù),即使用DXA測量出四肢肌肉量再除以身高的平方作為判定有無肌肉減少的指標(biāo),其推薦的切割點男性為7.23-7.26kg/m2,女性為5.5-5.67kg/m2。2014年,AWGS發(fā)布了針對亞洲人群的肌肉減少篩查切割點,使用DXA測算出肌肉指數(shù),如男性小于7.0 kg/m2或女性小于5.4 kg/m2則為肌肉減少。我們分別使用兩個工作組推薦的切割點得出本研究人群肌肉減少的患病率,并且分析了骨骼肌減少與其他臨床指標(biāo)的關(guān)系。結(jié)果：用亞洲肌少癥工作組的分割點時,男性肌肉減少患病率為45.9%,女性為36.7%；而參考?xì)W洲老年人肌少癥工作組的切割點時,男性肌肉減少患病率為56.6%,女性為28.6%。分別用兩種切割點作診斷標(biāo)準(zhǔn)時,男性肌肉減少患病率之間存在著統(tǒng)計學(xué)差異,而女性則否。使用多元線性回歸得出男性肌肉指數(shù)與全身肌肉指數(shù)(全身肌肉量／身高的平方)、BMI、腹部／臀部脂肪比值、TSH、HDL,而與估計的內(nèi)臟脂肪質(zhì)量、全身脂肪百分百、HbAlc和Hs-CRP呈負(fù)相關(guān)；女性肌肉指數(shù)與全身肌肉指數(shù)、BMI、髖關(guān)節(jié)骨密度T值、淋巴細(xì)胞計數(shù)、血漿前白蛋白、HDL呈正相關(guān),而與全身骨密度Z值、全身脂肪百分百、空腹血糖呈負(fù)相關(guān)。結(jié)論：中國老年人人群肌肉減少患病率較高,高的體重和低的代謝水平是肌少癥的保護(hù)因素,而肥胖、高血糖或糖尿病、營養(yǎng)不良和高水平的炎癥應(yīng)激是肌少癥的危險因素。
[Abstract]:Objective: in this study, we used two different types of sarcopenia recommended by the working group to assess the prevalence of myopenia in the elderly in hospital. Methods: this study included 694 elderly patients (male 324, female 370, female 370) who underwent DXA examination in the first affiliated Hospital of Chongqing Medical University. EWGSOP recommended the use of muscle index. Even if the DXA was used to measure the muscle mass of the limbs divided by the square of height as an indicator of muscle loss, the recommended cutting point for men was 7.23-7.26 kg / m2, and for women 5.5-5.67 kg / m2. 2014 AWGS released a screening cut point for muscle reduction in Asian populations. Using DXA to measure muscle index, if male is less than 7. 0 kg/m2 or female is less than 5. 4 kg/m2, we use cutting point recommended by two working groups to estimate the prevalence of muscle loss in this study population. The relationship between skeletal muscle reduction and other clinical indicators was also analyzed. Results: the prevalence of muscle reduction was 45.9 in males and 36.7 in females when the Asian oligocytopathic group was used as the division point, while referring to the cutting point of the European working group on oligocythemia in the elderly, the incidence of muscle reduction was 45.9 in males and 36.7 in females. The prevalence of muscle reduction was 56.6 in male and 28.6in female. There was statistical difference between male and female when using two cutting points as diagnostic criteria. But not in women. The multiple linear regression analysis showed that the male muscle index and body muscle index (BMI), abdominal / hip fat ratio (TSHHDL), and visceral fat mass (visceral fat mass) were estimated. There was a negative correlation between 100% HbAlc and Hs-CRP in whole body fat, positive correlation between female muscle index and BMI, T value of hip bone mineral density, lymphocyte count, plasma prealbumin HDL, but positive correlation with Z value of BMD and 100% of whole body fat. Conclusion: high body weight and low metabolic level are the protective factors of hypomyopathy, while obesity, hyperglycemia or diabetes mellitus. Malnutrition and high levels of inflammatory stress are risk factors for hypomyopathy.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R685

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