Emergency and Critical Care Medicine, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
Department of Rehabilitation, Akita University Hospital, 44-2 Hasunuma, Aza, Hiroomote, Akita 010-8543, Japan.
J Stroke Cerebrovasc Dis. 2021 Jun;30(6):105736. doi: 10.1016/j.jstrokecerebrovasdis.2021.105736. Epub 2021 Mar 20.
Muscle mass at admission is important to survive stroke, and stroke-induced sarcopenia is a serious problem because of its poor prognosis. Muscle mass measurement and monitoring are essential for appropriate rehabilitation and nutrition management. However, few reviews are available about the muscle mass measurement and monitoring after stroke.
Several methods are used to assess skeletal muscle mass in stroke, such as computed tomography (CT), ultrasound, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, biomarkers, and anthropometrics. We summarized the current methods and clinical applications in stroke.
In stroke, a head CT is used to estimate muscle mass by measuring the temporal muscle. However, it can be conducted retrospectively due to radiation exposure. After stroke, limb muscle atrophy and diaphragm dysfunction are observed using ultrasound. However, ultrasound requires an understanding of the methods and skill. A bioelectrical impedance analysis can be used to assess muscle mass in patients after a stroke unless they have dynamic fluid changes. Dual-energy X-ray absorptiometry is used for follow-up after hospital discharge. Urinary titin N-fragment and serum C-terminal agrin fragment reflect muscle atrophy after stroke. Anthropometrics may be useful with limited resources.
We summarized the features of each measurement and proved the recent evidence to properly measure and monitor skeletal muscle mass after stroke.
入院时的肌肉量对于脑卒中存活至关重要，而脑卒中引起的肌肉减少症是一个严重的问题，因为其预后不良。肌肉量的测量和监测对于适当的康复和营养管理至关重要。然而，关于脑卒中后肌肉量的测量和监测，目前仅有少量文献进行了综述。
有几种方法可用于评估脑卒中患者的骨骼肌量，如计算机断层扫描（CT）、超声、生物电阻抗分析、双能 X 射线吸收法、生物标志物和人体测量学。我们总结了目前脑卒中患者中使用的这些方法及其临床应用。
在脑卒中患者中，头部 CT 可通过测量颞肌来估计肌肉量，但由于辐射暴露，只能进行回顾性测量。脑卒中后，可通过超声观察到肢体肌肉萎缩和膈肌功能障碍。然而，超声需要掌握相关方法和技能。生物电阻抗分析可用于评估脑卒中后患者的肌肉量，除非患者有动态液体变化。双能 X 射线吸收法可用于出院后的随访。尿 Titin N 片段和血清 C 端凝集素片段反映脑卒中后肌肉萎缩。人体测量学在资源有限的情况下可能有用。
我们总结了每种测量方法的特点，并提供了最近的证据来正确测量和监测脑卒中后骨骼肌量。
