Maeda Keisuke, Akagi Junji
Department of Internal Medicine, Tamana Regional Health Medical Center, 2172 Tamana, Taman City, Kumamoto Prefecture, 865-0005, Japan,
Dysphagia. 2015 Feb;30(1):80-7. doi: 10.1007/s00455-014-9577-y. Epub 2014 Sep 24.
The aim of this study was to clarify the association between tongue pressure and factors related to sarcopenia such as aging, activities of daily living, nutritional state, and dysphagia. One-hundred-and-four patients without a history of treatment of stroke and without a diagnosis of neurodegenerative disease (36 men and 68 women), with a mean age of 84.1 ± 5.6 years, hospitalized from May 2013 to June 2013 were included in this study. Maximum voluntary tongue pressure against the palate (MTP) was measured by a device consisting of a disposable oral balloon probe. Nutritional and anthropometric parameters such as serum albumin concentration, Mini-Nutritional Assessment short form (MNA-SF), body mass index, arm muscle area (AMA), and others and presence of sarcopenia and dysphagia were analyzed to evaluate their relationships. Correlation analysis and univariate or multivariate analysis were performed. Simple correlation analysis showed that MTP correlated with Barthel index (BI), MNA-SF, serum albumin concentration, body mass index, and AMA. Univariate and multivariate analysis showed that sarcopenia, BI, MNA-SF, and age were the independent explanatory factors for decreased MTP, and the propensity score for dysphagia, including causes of primary or secondary sarcopenia, and the presence of sarcopenia were significantly associated with the presence of dysphagia. Decreased MTP and dysphagia were related to sarcopenia or the causes of sarcopenia in the studied population. Furthermore, the clinical condition of sarcopenic dysphagia may be partially interpreted as the presence of sarcopenia and causal factors for sarcopenia.
本研究旨在阐明舌压力与肌肉减少症相关因素之间的关联,这些因素包括衰老、日常生活活动能力、营养状况和吞咽困难。本研究纳入了2013年5月至2013年6月期间住院的104例无中风治疗史且未诊断为神经退行性疾病的患者(36例男性和68例女性),平均年龄为84.1±5.6岁。使用由一次性口腔气囊探头组成的设备测量最大自主舌对上颚的压力(MTP)。分析营养和人体测量参数,如血清白蛋白浓度、简易营养评估简表(MNA-SF)、体重指数、手臂肌肉面积(AMA)等,以及肌肉减少症和吞咽困难的存在情况,以评估它们之间的关系。进行了相关性分析以及单因素或多因素分析。简单相关性分析表明,MTP与Barthel指数(BI)、MNA-SF、血清白蛋白浓度、体重指数和AMA相关。单因素和多因素分析表明,肌肉减少症、BI、MNA-SF和年龄是MTP降低的独立解释因素,吞咽困难的倾向评分,包括原发性或继发性肌肉减少症的原因,以及肌肉减少症的存在与吞咽困难的存在显著相关。在研究人群中,MTP降低和吞咽困难与肌肉减少症或肌肉减少症的原因有关。此外,肌肉减少性吞咽困难的临床状况可能部分解释为肌肉减少症的存在以及肌肉减少症的因果因素。