Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan.
Department of Gastroenterology & Hepatology, Nagoya University Graduate School of Medicine, Japan.
Intern Med. 2021 May 1;60(9):1343-1348. doi: 10.2169/internalmedicine.6231-20. Epub 2020 Dec 7.
Objective We investigated the muscle cramp status of patients with liver cirrhosis by focusing on the degree of liver damage, skeletal muscle mass, and nutritional status. Methods All enrolled patients completed a questionnaire about muscle cramps. The degree of liver damage was examined using the Child-Pugh classification and the albumin-bilirubin (ALBI) grade. The nutritional status and skeletal muscle mass were examined using the Controlling Nutritional Status (CONUT) method and the psoas muscle index (PMI). Results Among the respondents, 55.7% of the patients reported experiencing muscle cramps. An analysis of the two patient groups-those who experienced muscle cramps and those who did not-revealed significant differences in Child-Pugh classification (muscle cramp-positive vs. muscle cramp-negative: A/B/C, 54.1%/32.4%/13.5% vs. 90.0%/10.0%/0.0%; p=0.004), ALBI grade (1/2/3, 20.5%/71.8%/7.7% vs. 54.8%/38.7%/6.5%; p=0.011), modified ALBI grade (1/2a/2b/3, 20.5%/20.5%/51.3%/7.7% vs. 54.8%/22.6%/16.1%/6.5%; p=0.008), CONUT score (normal/mild/moderate/severe, 25.6%/28.2%/41.0%/5.1% vs. 22.6%/61.3%/12.9%/3.2%; p=0.024), and PMI (3.85±1.13 cm/m vs. 4.94±1.86 cm/m; p=0.012). Conclusion Our findings suggest that muscle cramps occur more frequently in patients with liver cirrhosis due to their decreased liver function and poorer nutritional status.
通过关注肝损伤程度、骨骼肌量和营养状况,研究肝硬化患者的肌肉痉挛状况。
所有入组患者均完成了关于肌肉痉挛的问卷。采用Child-Pugh 分级和白蛋白-胆红素(ALBI)分级评估肝损伤程度,采用 CONTROLLING NUTRITIONAL STATUS(CONUT)方法和腰大肌指数(PMI)评估营养状况和骨骼肌量。
在应答者中,55.7%的患者报告有肌肉痉挛。对有肌肉痉挛和无肌肉痉挛的两组患者进行分析,发现 Child-Pugh 分级(肌肉痉挛阳性 vs. 肌肉痉挛阴性:A/B/C,54.1%/32.4%/13.5% vs. 90.0%/10.0%/0.0%;p=0.004)、ALBI 分级(1/2/3,20.5%/71.8%/7.7% vs. 54.8%/38.7%/6.5%;p=0.011)、改良 ALBI 分级(1/2a/2b/3,20.5%/20.5%/51.3%/7.7% vs. 54.8%/22.6%/16.1%/6.5%;p=0.008)、CONUT 评分(正常/轻度/中度/重度,25.6%/28.2%/41.0%/5.1% vs. 22.6%/61.3%/12.9%/3.2%;p=0.024)和 PMI(3.85±1.13 cm/m vs. 4.94±1.86 cm/m;p=0.012)在有肌肉痉挛和无肌肉痉挛的两组患者之间存在显著差异。
我们的研究结果表明,肌肉痉挛在肝功能下降和营养状况较差的肝硬化患者中更为常见。