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异基因造血干细胞移植患者骨骼肌的数量和质量对生存的影响。

Impact of the quantity and quality of the skeletal muscle on survival among patients undergoing allogeneic hematopoietic stem cell transplantation.

机构信息

Department of Rehabilitation Medicine, The Jikei University School of Medicine Hospital, Tokyo, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.

Department of Rehabilitation Medicine, The Jikei University School of Medicine Hospital, Tokyo, Japan.

出版信息

Leuk Res. 2023 May;128:107057. doi: 10.1016/j.leukres.2023.107057. Epub 2023 Mar 16.

Abstract

INTRODUCTION

Poor skeletal muscle function is relatively high in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT), leading to various negative health outcomes. This study aimed to investigate the relationship between the quantity and quality of skeletal muscle before transplantation and the short-to long-term survival after transplantation in patients undergoing allo-HSCT.

METHODS

This retrospective cohort study included 156 patients undergoing allo-HSCT (men, 67.3 %; median age, 53 years; interquartile range, 42-61 years). The quantity and quality of the skeletal muscle were measured at the psoas major at the level of the third lumbar vertebrae using a computed tomography (CT) and were defined as psoas muscle index (PMI) and CT values (CTV), respectively. The outcome measure of this study was overall survival (OS) after allo-HSCT, and we examined the relationship between survival at three time points (6, 12, and 24 months) after transplantation, PMI, and CTV.

RESULTS

PMI was significantly associated with survival at all time points in the crude model (P < 0.001), and a significant association was observed in the fully adjusted model (P < 0.01). CTV was significantly associated with survival at all time points in the crude model (P < 0.05), but not in the fully adjusted model (P > 0.05).

CONCLUSIONS

We found that the quantity and quality of the skeletal muscle before transplantation were significantly associated with OS at 6, 12, and 24 months after transplantation, showing a particularly robust association with quantity.

摘要

简介

异体造血干细胞移植(allo-HSCT)患者的骨骼肌功能较差,导致各种不良健康结局。本研究旨在探讨 allo-HSCT 患者移植前骨骼肌的数量和质量与移植后短期至长期生存的关系。

方法

本回顾性队列研究纳入了 156 例接受 allo-HSCT 的患者(男性,67.3%;中位年龄,53 岁;四分位间距,42-61 岁)。使用计算机断层扫描(CT)在第三腰椎水平测量腰大肌的数量和质量,并分别定义为腰大肌指数(PMI)和 CT 值(CTV)。本研究的结局测量指标为 allo-HSCT 后的总生存率(OS),我们检查了移植后 6、12 和 24 个月时生存情况、PMI 和 CTV 之间的关系。

结果

PMI 在粗模型中与所有时间点的生存均显著相关(P<0.001),在完全调整模型中也存在显著相关性(P<0.01)。CTV 在粗模型中与所有时间点的生存均显著相关(P<0.05),但在完全调整模型中无显著相关性(P>0.05)。

结论

我们发现移植前骨骼肌的数量和质量与移植后 6、12 和 24 个月的 OS 显著相关,与数量的相关性尤为显著。

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