【摘要】：目的:將歐洲老年人肌肉衰減癥工作組(EWGSOP)提出的肌肉質(zhì)量、肌肉力量和身體活動能力三維度綜合評定法應(yīng)用于上海市70~79歲社區(qū)老年女性肌肉衰減癥的篩檢研究中,以了解其檢測方法及代表性指標(biāo)是否適用于中國老年人群。方法:以上海市22位健康老年女性作為研究對象(老年組),另以10位青年女性作為參照對象(青年組),分別采用3D人體掃描法、生物電阻抗(BIA)法和雙能X射線(DEXA)法,在獲取四肢圍度的同時,以相對骨骼肌質(zhì)量指數(shù)(RASM)和骨骼肌指數(shù)(SMI)這兩項(xiàng)國際通用指標(biāo)對肌肉質(zhì)量進(jìn)行考量;采用握力計(jì)、Contrex等動訓(xùn)練儀對上、下肢肌肉力量進(jìn)行測評;采用10 m步速、功能性伸展測試(FRT)、計(jì)時起立行走(TUG)、Berg平衡量表(BBS)、軀體簡易功能量表(SPPB)等測試評定身體活動能力,最后參照EWGSOP共識就肌肉衰減癥的檢出率進(jìn)行初步判定。結(jié)果:(1)老年組上臂圍度和上肢脂肪量均較青年組顯著上升(P0.01),而上、下肢肌肉質(zhì)量均未見顯著變化(P0.05);(2)BIA法和DEXA法檢測結(jié)果顯示,老年組RASM值均顯著高于青年組(P0.05),SMI值均顯著低于青年組(P0.01);(3)老年組握力、相對握力、下肢三關(guān)節(jié)伸肌和屈肌的各項(xiàng)肌肉力量指標(biāo)均顯著低于青年組(P0.01),其中相對握力同下肢肌力多數(shù)指標(biāo)間相關(guān)性較為顯著;(4)老年組身體活動能力較青年組呈現(xiàn)顯著衰退趨勢(P0.05),且除握力和步速間存在顯著相關(guān)關(guān)系外,上肢肌力指標(biāo)同其他身體活動能力指標(biāo)間均未見顯著相關(guān)關(guān)系;(5)經(jīng)RASM指標(biāo)評估肌肉質(zhì)量維度時,BIA法和DEXA法所得檢出率均為0,而經(jīng)SMI指標(biāo)評估肌肉質(zhì)量維度時,相應(yīng)的檢出率分別為63.6%和45.4%。結(jié)論:本研究中EWGSOP共識應(yīng)用于篩檢肌肉衰減癥時存在指標(biāo)依賴性,建議在EWGSOP共識首推的"RASM+握力+步速"模式基礎(chǔ)上,適當(dāng)引入"SMI+相對握力+TUG/SPPB/Berg"模式進(jìn)行綜合判定,以避免對EWGSOP共識的簡單照搬。
[Abstract]:Objective: to apply the three-dimension comprehensive evaluation method of muscle mass, muscle strength and physical activity proposed by the European working Group on Muscular Attenuations of the elderly (EWGSOP) to the screening study of senile women's muscular attenuation in 7079-year-old community in Shanghai. To find out whether the test method and representative index are suitable for Chinese elderly population. Methods: a total of 22 healthy elderly women in Shanghai were selected as the study subjects (elderly group) and 10 young women as control subjects (youth group). Bioelectric impedance (BIA) method and dual-energy X-ray (DEXA) method were used to measure the muscle quality by using the relative skeletal muscle mass index (RASM) and the skeletal muscle index (SMI), which were used to measure the limb circumference at the same time as the relative skeletal muscle mass index (RASM) and the skeletal muscle index (SMI). The muscle strength of upper and lower limbs was measured by grip force meter and Contrex isokinetic training instrument. The body activity was evaluated by 10 m step speed, functional stretching test, (FRT), standing up and walking (TUG), Berg balance scale, (BBS), somatic mini-function scale, (SPPB), etc. Finally, according to the EWGSOP consensus, the detection rate of muscle attenuation was preliminarily determined. Results: (1) the upper arm circumference and upper limb fat content in the elderly group were significantly higher than those in the young group (P0.01), but the muscle mass of the upper and lower limbs had no significant change (P0.05). (2) the results of BIA and DEXA showed that the RASM value of the old group was significantly higher than that of the young group (P0.05), SMI value was significantly lower than that of the young group (P0.01); (3) grip strength, relative grip strength, muscle strength index of extensor muscle and flexor muscle of lower extremity in the elderly group were significantly lower than those in the young group (P0.01), and the correlation between relative grip strength and most indexes of lower limb muscle strength was significant. (4) the physical activity of the elderly group showed a significant decline trend compared with the young group (P0.05), and there was no significant correlation between the upper limb muscle strength index and other physical activity indicators except for the significant correlation between grip strength and walking speed. (5) when the muscle quality dimension was evaluated by RASM, the detection rates of BIA and DEXA were both 0, while those of SMI were 63.6% and 45.4%, respectively. Conclusion: in this study, the application of EWGSOP consensus in the screening of muscle attenuation has index dependence. It is suggested that the "SMI relative grip strength TUG/SPPB/Berg" model should be introduced on the basis of the "RASM grip step speed" model recommended by the EWGSOP consensus. To avoid a simple copy of the EWGSOP consensus.
【作者單位】： 浙江工業(yè)大學(xué)體育科學(xué)研究所;上海體育學(xué)院運(yùn)動科學(xué)學(xué)院;美國俄勒岡州立大學(xué);
【基金】：中國博士后科學(xué)基金項(xiàng)目(2012T50430&2011M500805) 浙江省體育局科研項(xiàng)目(2013[334]-22)
【分類號】：R685

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