肌肉减少症作为外周动脉疾病的预后因素：描述性综述。
Sarcopenia as a Prognostic Factor in Peripheral Arterial Disease: Descriptive Review.
机构信息
Vascular Surgery Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Medicine Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Internal Medicine Department, Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Hospital da Senhora da Oliveira, Guimarães, Portugal.
出版信息
Ann Vasc Surg. 2021 Jul;74:460-474. doi: 10.1016/j.avsg.2021.01.076. Epub 2021 Feb 5.
BACKGROUND
Determine the influence of sarcopenia on the prognosis of peripheral arterial disease (PAD).
METHODS
A systematic search of the PubMed and Cochrane Library databases was performed with the keywords and medical subject heading (MesH): "muscle, skeletal", "sarcopenia", "prognosis", "duration of stay", "death", "mortality", "patient readmission", "length of stay", "peripheral arterial disease", "intermittent claudication" and "critical limb ischemia". Papers published from January 2010 to October 2020 in English, French, Spanish and Portuguese were eligible for inclusion. The primary outcome was overall survival. Secondary outcomes included post-operative complications, amputation, length of hospital stay and hospital readmission.
RESULTS
Of 1071 papers, 8 articles and 1511 patients were included (68.96% male, mean age 71.83 years). Five papers found an inverse relationship between SM area and mortality. Matsubara (2015) found that the 5-year overall survival rates were lower for patients with sarcopenia (23.5% ± 0.18% vs 77.5% ± 0.09% P = 0.001). Matsubara (2016) registered 3-year cardiovascular event-free survival rates of 43.1% and 91.2% for patients with and without sarcopenia (P < 0.01). Juszczak (2018) found that survival was lower in patients with reduced total psoas area. Taniguchi (2019) found that 3-year overall survival rate was 60% for patients with sarcopenia and 87% for patients without sarcopenia (P < 0.05). Shimazoe (2019) concluded sarcopenia was a significant predictor of overall survival. Distinctly, Nyers (2017) concluded that higher ratio bilateral psoas area to L4 vertebral body was associated with an increased risk of death. Two other studies analyzed other characteristics of the SM (density and strength). McDermott (2012) and found that lower calf muscle density and strength were associated with an increase in mortality. Sugai (2019) concluded that patients with major cardiovascular and limb events had a lower SM density.
CONCLUSIONS
Lower SM area and mass seem to be associated with a higher mortality in PAD patients.
背景
确定肌肉减少症对周围动脉疾病（PAD）预后的影响。
方法
使用关键词和医学主题词（MeSH）：“肌肉，骨骼”，“肌肉减少症”，“预后”，“住院时间”，“死亡”，“死亡率”，“患者再入院”，“住院时间”，“周围动脉疾病”，“间歇性跛行”和“肢体严重缺血”，对 PubMed 和 Cochrane Library 数据库进行了系统搜索。符合条件的文献为 2010 年 1 月至 2020 年 10 月间发表的英文、法文、西班牙文和葡萄牙文文献。主要结局为总生存率。次要结局包括术后并发症、截肢、住院时间和医院再入院。
结果
在 1071 篇论文中，纳入了 8 篇文章和 1511 名患者（68.96%为男性，平均年龄 71.83 岁）。五项研究发现，SM 面积与死亡率呈反比关系。松永（2015）发现，肌肉减少症患者的 5 年总生存率较低（23.5%±0.18%比 77.5%±0.09%，P=0.001）。松永（2016）登记了 3 年无心血管事件生存率，肌肉减少症患者为 43.1%，无肌肉减少症患者为 91.2%（P＜0.01）。扬恰克（2018）发现，总腹直肌面积减少的患者生存率较低。谷口（2019）发现，肌肉减少症患者 3 年总生存率为 60%，无肌肉减少症患者为 87%（P＜0.05）。岛泽（2019）得出结论，肌肉减少症是总生存率的显著预测因子。相反，尼尔斯（2017）得出结论，双侧竖脊肌面积与 L4 椎体面积的比值较高与死亡风险增加相关。另外两项研究分析了 SM 的其他特征（密度和强度）。麦克德莫特（2012）发现，小腿肌肉密度和强度较低与死亡率增加相关。菅井（2019）得出结论，发生主要心血管和肢体事件的患者 SM 密度较低。
结论
较低的 SM 面积和质量似乎与 PAD 患者的死亡率增加有关。
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