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急性肌肉减少症:机制与管理。

Acute Sarcopenia: Mechanisms and Management.

机构信息

Internal Medicine Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Division of Immunology, Transplantation and Infectious Diseases, Vita-Salute San Raffaele University, 20100 Milan, Italy.

出版信息

Nutrients. 2024 Oct 10;16(20):3428. doi: 10.3390/nu16203428.

Abstract

BACKGROUND

Acute sarcopenia refers to the swift decline in muscle function and mass following acute events such as illness, surgery, trauma, or burns that presents significant challenges in hospitalized older adults.

METHODS

narrative review to describe the mechanisms and management of acute sarcopenia.

RESULTS

The prevalence of acute sarcopenia ranges from 28% to 69%, likely underdiagnosed due to the absence of muscle mass and function assessments in most clinical settings. Systemic inflammation, immune-endocrine dysregulation, and anabolic resistance are identified as key pathophysiological factors. Interventions include early mobilization, resistance exercise, neuromuscular electrical stimulation, and nutritional strategies such as protein supplementation, leucine, β-hydroxy-β-methyl-butyrate, omega-3 fatty acids, and creatine monohydrate. Pharmaceuticals show variable efficacy.

CONCLUSIONS

Future research should prioritize serial monitoring of muscle parameters, identification of predictive biomarkers, and the involvement of multidisciplinary teams from hospital admission to address sarcopenia. Early and targeted interventions are crucial to improve outcomes and prevent long-term disability associated with acute sarcopenia.

摘要

背景

急性肌少症是指在疾病、手术、创伤或烧伤等急性事件后,肌肉功能和质量迅速下降,这给住院老年患者带来了重大挑战。

方法

对描述急性肌少症的机制和管理的叙述性文献进行综述。

结果

急性肌少症的患病率为 28%至 69%,由于大多数临床环境中缺乏肌肉质量和功能评估,其可能被低估。全身性炎症、免疫内分泌失调和合成代谢抵抗被确定为关键的病理生理因素。干预措施包括早期活动、抗阻运动、神经肌肉电刺激以及营养策略,如蛋白质补充、亮氨酸、β-羟基-β-甲基丁酸、ω-3 脂肪酸和肌酸一水合物。药物的疗效存在差异。

结论

未来的研究应优先考虑对肌肉参数进行连续监测,确定预测性生物标志物,并在患者住院期间就涉及多学科团队来解决肌少症问题。早期和有针对性的干预措施对于改善急性肌少症相关的预后和预防长期残疾至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0deb/11510680/ec5ce209941a/nutrients-16-03428-g001.jpg

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