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探讨缺血性脑卒中患者的身体成分、代谢特征和骨骼肌功能能力的变化:脑卒中患者体型研究(BoSSS)的原理和设计。

Investigation of changes in body composition, metabolic profile and skeletal muscle functional capacity in ischemic stroke patients: the rationale and design of the Body Size in Stroke Study (BoSSS).

机构信息

Center for Stroke Research Berlin-CSB, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

出版信息

J Cachexia Sarcopenia Muscle. 2013 Sep;4(3):199-207. doi: 10.1007/s13539-013-0103-0. Epub 2013 Mar 13.

Abstract

BACKGROUND

Stroke is steadily increasing in prevalence. Muscle tissue wasting and functional changes are frequently observed in stroke, but this has not been studied in detail yet. There is a lack of data to support guideline recommendations on how to target muscle wasting in stroke patients. We hypothesise that pathophysiological metabolic profiles and muscle functional and structural impairment are developing in stroke patients, which are associated with stroke severity and outcome after stroke.

METHODS

The Body Size in Stroke Study (BoSSS) is a prospective, longitudinal observation study that will explore associations between the metabolic profile, body tissue wasting and particular metabolic and functional changes in skeletal muscle tissue in stroke patients. Consecutive patients with acute stroke (n = 150) will be enrolled due to lacunar or territorial ischemic infarct in the area of the middle cerebral artery. Patients will be studied at annual intervals after 12 and 24 months. For comparison, healthy controls of similar age and patients with chronic heart failure will be used as control groups. The main objective is to study changes in body composition in stroke patients. Secondary, the study will focus on changes in insulin sensitivity of adipose tissue and skeletal muscle. Furthermore, measurements of endothelial function and peripheral blood flow will provide insight in the vascular regulation in stroke patients.

CONCLUSION

This study will be the largest observational study providing insights into the metabolic and functional changes of muscle tissue in patients with acute ischemic stroke. The new data will increase our understanding of the pathophysiologic tissue wasting in stroke disease and help to develop new therapeutic strategies.

摘要

背景

中风的发病率稳步上升。中风患者经常出现肌肉组织萎缩和功能变化,但这尚未得到详细研究。缺乏数据支持指南建议如何针对中风患者的肌肉萎缩。我们假设中风患者存在生理代谢特征以及肌肉功能和结构损伤,这些与中风严重程度和中风后结果相关。

方法

体型与中风研究(BoSSS)是一项前瞻性、纵向观察研究,将探讨代谢特征、身体组织消耗以及中风患者骨骼肌组织中特定代谢和功能变化之间的关联。由于大脑中动脉区域的腔隙或区域性缺血性梗死,将连续纳入 150 例急性中风患者。患者将在 12 个月和 24 个月后每年进行研究。为了进行比较,将使用年龄相似的健康对照者和慢性心力衰竭患者作为对照组。主要目的是研究中风患者的身体成分变化。其次,该研究将重点关注脂肪组织和骨骼肌胰岛素敏感性的变化。此外,内皮功能和外周血流的测量将深入了解中风患者的血管调节。

结论

这将是最大规模的观察性研究,提供对急性缺血性中风患者肌肉组织代谢和功能变化的深入了解。新数据将增加我们对中风疾病中病理生理组织消耗的理解,并有助于开发新的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba26/3774919/57464ae2ab47/13539_2013_103_Fig1_HTML.jpg

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