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血液系统恶性肿瘤患者的肌肉功能特征及恶病质的影响

Characteristics of muscle function and the effect of cachexia in patients with haematological malignancy.

作者信息

Fukushima Takuya, Nakano Jiro, Ishii Shun, Natsuzako Ayumi, Hirase Tatsuya, Sakamoto Junya, Okita Minoru

机构信息

Department of Locomotive Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Department of Rehabilitation, Nagasaki University Hospital, Nagasaki, Japan.

出版信息

Eur J Cancer Care (Engl). 2019 Mar;28(2):e12956. doi: 10.1111/ecc.12956. Epub 2018 Oct 25.

Abstract

OBJECTIVE

In this study, we investigated the muscle function of patients with haematological malignancy and healthy controls and examined the effect of cachexia on muscle function.

METHODS

Seventy-one patients with haematological malignancy, hospitalised for chemotherapy, and 71 healthy controls underwent examination of skeletal muscle mass (SMM; total body and upper and lower limbs), handgrip strength and isometric knee extensor strength. Patients with haematological malignancy were divided into three groups based on Glasgow Prognostic Score: non-cachexia (n = 31), pre-cachexia (n = 23) and cachexia (n = 17) groups. The evaluation items were compared among the groups.

RESULTS

Patients with haematological malignancy had lower SMM of the total body and lower limbs, handgrip strength and isometric knee extensor strength than healthy controls. There was no significant difference in SMM of the upper limbs among the groups. When classifying patients with haematological malignancy according to GPS, there was no significant difference among the three groups for any of the evaluation items.

CONCLUSIONS

In patients with haematological malignancy, although significant muscle wasting and weakness were observed in the lower limbs, the effect of cachexia was minimal. The reduction in muscle function involved disuse syndrome, which accompanied a decline in physical activity.

摘要

目的

在本研究中,我们调查了血液系统恶性肿瘤患者和健康对照者的肌肉功能,并研究了恶病质对肌肉功能的影响。

方法

71例因化疗住院的血液系统恶性肿瘤患者和71名健康对照者接受了骨骼肌质量(SMM;全身及上下肢)、握力和等长膝关节伸展力量的检查。根据格拉斯哥预后评分,将血液系统恶性肿瘤患者分为三组:非恶病质组(n = 31)、恶病质前期组(n = 23)和恶病质组(n = 17)。对各组间的评估项目进行比较。

结果

血液系统恶性肿瘤患者的全身和下肢SMM、握力和等长膝关节伸展力量均低于健康对照者。各组间上肢SMM无显著差异。根据GPS对血液系统恶性肿瘤患者进行分类时,三组间任何评估项目均无显著差异。

结论

在血液系统恶性肿瘤患者中,虽然下肢出现了明显的肌肉萎缩和无力,但恶病质的影响最小。肌肉功能的下降涉及废用综合征,这伴随着身体活动的减少。

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