Nagaoka Utako, Shimizu Toshio, Matsukura Tokiko, Takeda Mayumi
Department of Neurology, Tokyo Metropolitan Neurological Hospital.
Rinsho Shinkeigaku. 2010 Mar;50(3):141-6. doi: 10.5692/clinicalneurol.50.141.
We investigated nutritional states of 28 patients with multiple system atrophy (MSA) by measuring body mass index (BMI), arm muscle circumference (% AMC) and triceps skin fold thickness (% TSF). We also analyzed retrospectively chronological changes of nutritional status in 13 MSA patients surviving more than 10 years. BMI and % AMC were significantly reduced in patients having tube feeding compared with patients who had oral intake, whereas % TSF was increased in some patients with tube feeding. From the chronological study, patients at the stage of respiratory or swallowing deterioration showed marked malnutrition, whereas patients during the advanced, but stable stages with tracheostomy and gastrostomy showed much fat accumulation even under low calorie intake less than 1,000 kcal/day. Daily amount of calorie intake should be sufficient during respiratory or swallowing deterioration, but it should be restricted at the advanced stable stage to avoid fat accumulation.
我们通过测量体重指数（BMI）、上臂肌肉围（%AMC）和肱三头肌皮褶厚度（%TSF），对28例多系统萎缩（MSA）患者的营养状况进行了调查。我们还回顾性分析了13例存活超过10年的MSA患者营养状况随时间的变化。与经口进食的患者相比，接受管饲的患者BMI和%AMC显著降低，而部分接受管饲的患者%TSF升高。从时间研究来看，处于呼吸或吞咽功能恶化阶段的患者表现出明显的营养不良，而处于晚期但病情稳定且行气管造口术和胃造口术的患者，即使在每日热量摄入低于1000千卡的情况下，仍有大量脂肪堆积。在呼吸或吞咽功能恶化期间，每日热量摄入量应充足，但在晚期稳定阶段应加以限制，以避免脂肪堆积。
