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超声作为一种有前途的卒中相关肌少症诊断工具的效用:一项回顾性初步研究。

Utility of ultrasound as a promising diagnostic tool for stroke-related sarcopenia: A retrospective pilot study.

机构信息

Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.

Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.

出版信息

Medicine (Baltimore). 2022 Sep 9;101(36):e30245. doi: 10.1097/MD.0000000000030244.

Abstract

Stroke patients undergo extensive changes in muscle mass which lead to stroke-related sarcopenia. Stroke-related sarcopenia has a significant impact on the functional outcome of stroke survivors. So, it is important to measure muscle mass in stroke patients. This study aimed to examine the correlation between ultrasonographic quadriceps muscle thickness (QMT) and dual-energy X-ray absorptiometry (DXA) derived appendicular lean mass (ALM) in patients with acute hemiplegic stroke. Twenty five participants were included (13 men and 12 women) in this study, who were diagnosed with stroke within 1 month. For both paretic and non-paretic legs, QMT was measured by an ultrasound and ALM was obtained by performing DXA scan. We analyzed the difference and the correlation between ultrasonographic QMT and DXA-derived lean body mass of both paretic and non-paretic legs. Stroke patients were divided into 2 groups according to the paretic knee extensor power. Ultrasonographic QMT, DXA scan findings, and functional parameters were compared. There was a significant correlation between QMT and ALM index, and between QMT and site-specific lean mass (SSLM) of both the legs for both the sexes (P < .05). In multivariate linear regression model, we made adjustments for the confounding factors of age, sex, body mass index (BMI) and paretic knee extensor power. We observed a positive relationship between QMT and ALM index (P < .05), and between QMT and SSLM of both the legs (P < .05). The % QMT showed higher difference than % SSLM between paretic and non-paretic legs (10.25% vs 4.58%). The QMT measurements of ultrasound show a great relationship with DXA scan findings. Ultrasound better reflects the change of muscle mass between paretic and non-paretic legs than DXA scan at an acute phase of stroke. Ultrasound could be a useful tool to evaluate stroke-related sarcopenia.

摘要

脑卒中患者的肌肉量会发生广泛变化,导致与脑卒中相关的肌肉减少症。与脑卒中相关的肌肉减少症对脑卒中幸存者的功能预后有重大影响。因此,测量脑卒中患者的肌肉量非常重要。本研究旨在探讨急性偏瘫脑卒中患者的超声股四头肌厚度(QMT)与双能 X 射线吸收法(DXA)测定的四肢瘦体重(ALM)之间的相关性。本研究共纳入 25 名参与者(13 名男性和 12 名女性),这些参与者均在脑卒中发病后 1 个月内被确诊。对于患侧和非患侧肢体,均通过超声测量 QMT,通过 DXA 扫描获得 ALM。我们分析了患侧和非患侧肢体的超声 QMT 与 DXA 测定的瘦体重之间的差异和相关性。根据患侧膝关节伸肌力量,将脑卒中患者分为 2 组。比较了超声 QMT、DXA 扫描结果和功能参数。对于两性,QMT 与 ALM 指数之间,以及 QMT 与双侧肢体的部位特异性瘦体重(SSLM)之间均存在显著相关性(P<.05)。在多元线性回归模型中,我们对年龄、性别、体重指数(BMI)和患侧膝关节伸肌力量等混杂因素进行了调整。我们观察到 QMT 与 ALM 指数之间存在正相关关系(P<.05),以及 QMT 与双侧肢体的 SSLM 之间存在正相关关系(P<.05)。与非患侧肢体相比,患侧肢体的 QMT 与 SSLM 之间的差异更大(10.25% vs 4.58%)。与 DXA 扫描相比,QMT 对患侧和非患侧肢体肌肉量的变化的反应更敏感。在脑卒中的急性期,超声比 DXA 扫描更能反映患侧和非患侧肢体之间的肌肉量变化。超声可能是评估与脑卒中相关的肌肉减少症的一种有用工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cfc/10550012/5474c0e3c1a4/medi-101-e30245-g001.jpg

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