影响超急性卒中患者身体成分和营养状况变化的因素：前瞻性研究
Factors influencing changes in body composition and nutritional status in patients with hyperacute stroke: prospective study.
作者信息
Irisawa Hiroshi, Nakamura Tomoyuki, Chiba Yumi, Hirota Mitsuki, Hoshiai Hajime, Mizushima Takashi
机构信息
Department of Rehabilitation Medicine, Dokkyo Medical University, Mibu, Japan.
出版信息
Front Nutr. 2025 Mar 18;12:1548796. doi: 10.3389/fnut.2025.1548796. eCollection 2025.
BACKGROUND AND AIMS
Muscle loss not only reduce the effectiveness of the recovery period of rehabilitation after stroke but also prolongs the length of hospital stay. Therefore, it is crucial to maintain muscle mass during the hyperacute phase of stroke. We aimed to investigate the factor that influence changes in muscle mass and quality in patients with hyperacute stroke by using a body composition analyzer.
METHODS
Body composition assessment was performed on 156 patients admitted to the stroke care unit at the time of admission and 1 week later. Additionally, associations between rehabilitation intervention time, nutritional dosage and administration method, and stroke severity were examined to which factors were affecting body composition.
RESULTS
Muscle mass and quality significantly decreased in both men (SMI: 7.41 ± 1.26 to 7.22 ± 1.23 kg/m, < 0.005, phA: 5.5 ± 1.24 to 5.31 ± 1.29 degree, < 0.005) and women (SMI: 6.04 ± 1.30 to 5.08 ± 1.20 kg/m2, < 0.005, phA: 4.58 ± 0.85 to4.18 ± 0.82 degree, < 0.005)1 week after admission. Rehabilitation intervention time [odds ratio (OR) = 2.12; 95% CI: 1.28-4.47, = 0.01], and high calorie dosage (OR = 1.53; 95% CI: 1.14-3.21, = 0.03) significantly reduced the loss of muscle mass. However, stroke severity did not affect variations in body composition.
CONCLUSION
Deterioration in muscle mass and quality was observed during the hyperacute phase of stroke. The risk of muscle mass loss may be reduced with appropriate rehabilitation intervention and diet therapy from the early stage of hospitalization. Therefore, providing early rehabilitation intervention and nutritional management in the hospitalization phase are important to improve treatment effectiveness. In hyperacute stroke treatment, rehabilitation and nutritional administration should be provided as early as possible.
CLINICAL TRIAL REGISTRATION
https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000053017, identifier UMIN-CTR UMIN000046467.
背景与目的
肌肉流失不仅会降低中风后康复恢复期的效果，还会延长住院时间。因此，在中风超急性期维持肌肉量至关重要。我们旨在通过使用身体成分分析仪，研究影响超急性中风患者肌肉量和质量变化的因素。
方法
对156名入住中风护理单元的患者在入院时和1周后进行身体成分评估。此外，检查康复干预时间、营养剂量和给药方法与中风严重程度之间的关联，以确定哪些因素会影响身体成分。
结果
入院1周后，男性（肌肉质量指数：7.41±1.26至7.22±1.23kg/m，<0.005；相位角：5.5±1.24至5.31±1.29度，<0.005）和女性（肌肉质量指数：6.04±1.30至5.08±1.20kg/m²，<0.005；相位角：4.58±0.85至4.18±0.82度，<0.005）的肌肉量和质量均显著下降。康复干预时间[比值比（OR）=2.12；95%置信区间：1.28 - 4.47，=0.01]和高热量剂量（OR = 1.53；95%置信区间：1.14 - 3.21，=0.03）显著降低了肌肉量的流失。然而，中风严重程度并未影响身体成分的变化。
结论
在中风超急性期观察到肌肉量和质量恶化。从住院早期进行适当的康复干预和饮食治疗，可能会降低肌肉量流失的风险。因此，在住院阶段提供早期康复干预和营养管理对于提高治疗效果很重要。在超急性中风治疗中，应尽早提供康复和营养管理。
临床试验注册
https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000053017，标识符UMIN - CTR UMIN000046467 。
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