Nozoe Masafumi, Kanai Masashi, Kubo Hiroki, Kitamura Yuka, Yamamoto Miho, Furuichi Asami, Takashima Sachie, Mase Kyoshi, Shimada Shinichi
Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan; Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
J Stroke Cerebrovasc Dis. 2016 Oct;25(10):2470-4. doi: 10.1016/j.jstrokecerebrovasdis.2016.06.020. Epub 2016 Jul 4.
Lower leg muscle wasting is common in stroke patients; however, patient characteristics in the acute phase are rarely studied. This study aimed to examine the relationship between changes in quadriceps muscle thickness and disease severity, nutritional status, and C-reactive protein (CRP) levels after acute stroke.
Thirty-one consecutive patients with acute intracerebral hemorrhage or ischemic stroke had quadriceps muscle thickness measured in the paretic and nonparetic limbs within 1 week after admission (first week) and 2 weeks after the first examination (last week) using ultrasonography. We also determined the relationship between the percentage change in muscle thickness and disease severity, nutritional status, and CRP levels on admission.
There was a significant correlation between changes in muscle thickness for both paretic and nonparetic sides and National Institutes of Health Stroke Scale (NIHSS) scores (paretic limb: r = -.46, P = .01; nonparetic limb: r = -.54, P = .002, respectively); however, there was no significant correlation with nutritional status on admission. Quadriceps muscle thickness was reduced more in the CRP-positive (≥.3 mg/dL) patients than in the CRP-negative (<.3 mg/dL) patients in the nonparetic limb (positive: -21.4 ± 12.1, negative: -11.4 ± 16.4%; P = .039), but not in the paretic limb (positive: -23.4 ± 9.0, negative: -19.1 ± 15.7; P = .27).
A high NIHSS score and a positive CRP on admission were both significantly correlated with decreased quadriceps muscle thickness after acute stroke. Nutritional status on admission was not correlated with changes in quadriceps muscle thickness for these patients.
小腿肌肉萎缩在中风患者中很常见；然而，急性期患者的特征很少被研究。本研究旨在探讨急性中风后股四头肌厚度变化与疾病严重程度、营养状况及C反应蛋白（CRP）水平之间的关系。
31例连续的急性脑出血或缺血性中风患者在入院后1周内（第一周）及首次检查后2周（最后一周），使用超声测量患侧和非患侧肢体的股四头肌厚度。我们还确定了入院时肌肉厚度百分比变化与疾病严重程度、营养状况及CRP水平之间的关系。
患侧和非患侧肌肉厚度变化与美国国立卫生研究院卒中量表（NIHSS）评分均显著相关（患侧肢体：r = -0.46，P = 0.01；非患侧肢体：r = -0.54，P = 0.002）；然而，与入院时的营养状况无显著相关性。非患侧肢体中，CRP阳性（≥0.3mg/dL）患者的股四头肌厚度降低幅度大于CRP阴性（<0.3mg/dL）患者（阳性：-21.4±12.1，阴性：-11.4±16.4%；P = 0.039），但患侧肢体无此差异（阳性：-23.4±9.0，阴性：-19.1±15.7；P = 0.27）。
急性中风后，高NIHSS评分和入院时CRP阳性均与股四头肌厚度降低显著相关。这些患者入院时的营养状况与股四头肌厚度变化无关。
