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肌少性吞咽障碍再探讨:住院老年患者的横断面研究。

Sarcopenic Dysphagia Revisited: A Cross-Sectional Study in Hospitalized Geriatric Patients.

机构信息

Department of Geriatric Medicine, Marien Hospital Herne, Ruhr University Bochum, 44625 Herne, Germany.

Department of Neurology, University Hospital Münster, 48149 Münster, Germany.

出版信息

Nutrients. 2023 Jun 7;15(12):2662. doi: 10.3390/nu15122662.

Abstract

Oropharyngeal dysphagia (OD) is a frequent finding in older patients with potentially lethal complications such as aspiration pneumonia, malnutrition, and dehydration. Recent studies describe sarcopenia as a causative factor for OD, which is occasionally referred to as "sarcopenic dysphagia" in the absence of a neurogenic etiology. In most of the previous studies on sarcopenic dysphagia, the diagnosis was based only on clinical assessment. In this study, flexible endoscopic evaluation of swallowing (FEES) was used as an objective method to evaluate the presence of OD, its association with sarcopenia, and the presence of pure sarcopenic dysphagia. In this retrospective cross-sectional study, 109 acute care geriatric hospital patients with suspected OD received FEES examination and bioimpedance analysis (BIA) in clinical routine. 95% of patients had at least one neurological disease, 70% fulfilled the criteria for sarcopenia, and 45% displayed moderate or severe OD. Although the prevalence of sarcopenia and OD was high, there was no significant association between OD and sarcopenia. Considering these results, both the association between sarcopenia and OD and pure sarcopenic dysphagia appear questionable. Further prospective studies are needed to elucidate if sarcopenia is merely an epiphenomenon of severe disease or whether it plays a causative role in the development of OD.

摘要

口咽吞咽困难(OD)是老年患者中常见的问题,可能导致致命并发症,如吸入性肺炎、营养不良和脱水。最近的研究表明,肌少症是 OD 的一个致病因素,在没有神经源性病因的情况下,OD 偶尔被称为“肌少症性吞咽困难”。在大多数关于肌少症性吞咽困难的先前研究中,诊断仅基于临床评估。在这项研究中,使用灵活的内镜吞咽评估(FEES)作为一种客观方法来评估 OD 的存在、其与肌少症的关系以及纯肌少症性吞咽困难的存在。在这项回顾性横断面研究中,109 名疑似 OD 的急性护理老年医院患者在临床常规中接受了 FEES 检查和生物阻抗分析(BIA)。95%的患者至少有一种神经系统疾病,70%符合肌少症标准,45%显示中度或重度 OD。尽管肌少症和 OD 的患病率很高,但 OD 与肌少症之间没有显著关联。考虑到这些结果,肌少症与 OD 之间的关联以及纯肌少症性吞咽困难似乎值得怀疑。需要进一步的前瞻性研究来阐明肌少症是否仅仅是严重疾病的一种表现,或者它是否在 OD 的发展中起因果作用。

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