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[慢性阻塞性肺疾病急性加重期住院患者的肌肉减少症指数]

[Sarcopenia index in hospitalized patients with chronic obstructive pulmonary disease exacerbation].

作者信息

Warnken-Miralles Manuel D, López-García Francisco, Zamora-Molina Lucía, Soler-Sempere María J, Padilla-Navas Isabel, García-Pachón Eduardo

机构信息

Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Alicante, España.

Servicio de Medicina Interna, Hospital General Universitario de Elche, Elche, Alicante, España.

出版信息

Medicina (B Aires). 2021;81(3):323-328.

PMID:34137690
Abstract

Sarcopenia (loss of muscle mass and function) implies a worse prognosis. However, its diagnosis is complex and is not made in routine clinical care. A biomarker has been proposed as a surrogate estimator of skeletal muscle mass, the so-called sarcopenia index ([serum creatinine/cystatine C] x100) which is associated with prognostic features in various diseases including patients with stable chronic obstructive pulmonary disease (COPD). The aim of our study was to prospectively evaluate the potential clinical and prognostic information of this biomarker in COPD exacerbation. This is a one-year prospective study of consecutive patients admitted for COPD exacerbation. A total of 89 patients, 70 men (79%) and 19 women (21%) were included. Those with lower values of the sarcopenia index had a higher level of dyspnoea and a longer hospitalization. In the correlation analysis, the index had statistically significant values with FEV1 (r = 0.23), PaCO2 (r = -0.30), bicarbonate (r = -0.31), dyspnoea (r = -0.25) and length of admission (r = -0.30). In patients admitted for COPD exacerbation, the sarcopenia index was related to prognostic characteristics, so that lower values were associated with longer duration of hospital admission, more dyspnoea and greater functional impairment. As this is an index associated with muscle mass, its determination may identify patients who could be the subject of a differentiated therapeutic plan.

摘要

肌肉减少症(肌肉质量和功能丧失)意味着预后较差。然而,其诊断复杂,在常规临床护理中无法进行。一种生物标志物已被提议作为骨骼肌质量的替代估计指标,即所谓的肌肉减少症指数([血清肌酐/胱抑素C]×100),它与包括稳定期慢性阻塞性肺疾病(COPD)患者在内的各种疾病的预后特征相关。我们研究的目的是前瞻性评估这种生物标志物在COPD急性加重期的潜在临床和预后信息。这是一项对因COPD急性加重而入院的连续患者进行的为期一年的前瞻性研究。共纳入89例患者,其中70例男性(79%)和19例女性(21%)。肌肉减少症指数值较低的患者呼吸困难程度较高且住院时间较长。在相关性分析中,该指数与第一秒用力呼气容积(FEV1)(r = 0.23)、动脉血二氧化碳分压(PaCO2)(r = -0.30)、碳酸氢盐(r = -0.31)、呼吸困难(r = -0.25)及住院时间(r = -0.30)具有统计学显著相关性。在因COPD急性加重而入院的患者中,肌肉减少症指数与预后特征相关,即较低的值与更长的住院时间、更严重的呼吸困难及更严重的功能损害相关。由于这是一个与肌肉质量相关的指数,其测定可能识别出可作为差异化治疗计划对象的患者。

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引用本文的文献

1
[Prognostic Value of Serum Creatinine to Cystatin C Ratio in Hospitalized Patients With Chronic Obstructive Pulmonary Disease].血清肌酐与胱抑素C比值对慢性阻塞性肺疾病住院患者的预后价值
Open Respir Arch. 2022 Jun 9;4(4):100187. doi: 10.1016/j.opresp.2022.100187. eCollection 2022 Oct-Dec.
2
Prevalence of sarcopenia in patients with COPD through different musculature measurements: An updated meta-analysis and meta-regression.通过不同肌肉测量方法评估慢性阻塞性肺疾病患者肌肉减少症的患病率:一项更新的荟萃分析和元回归分析
Front Nutr. 2023 Feb 16;10:1137371. doi: 10.3389/fnut.2023.1137371. eCollection 2023.
3
Serum Creatinine/Cystatin C Ratio as a Predictor of In-hospital Mortality in Patients Hospitalized with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.
血清肌酐/胱抑素 C 比值可预测慢性阻塞性肺疾病急性加重住院患者的院内死亡率。
Lung. 2022 Oct;200(5):609-617. doi: 10.1007/s00408-022-00568-5. Epub 2022 Sep 15.
4
Serum Creatinine to Cystatin C Ratio is an Effective Indicator for Muscle Strength Decline in Men with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.血清肌酐与胱抑素 C 比值是预测男性慢性阻塞性肺疾病急性加重期肌肉力量下降的有效指标。
Int J Chron Obstruct Pulmon Dis. 2022 Apr 8;17:781-789. doi: 10.2147/COPD.S356314. eCollection 2022.