Ionescu A A, Chatham K, Davies C A, Nixon L S, Enright S, Shale D J
Section of Respiratory Medicine, University of Wales College of Medicine, Llandough Hospital and Community NHS Trust, Penarth, South Glamorgan, CF64 2XX, UK.
Am J Respir Crit Care Med. 1998 Oct;158(4):1271-6. doi: 10.1164/ajrccm.158.4.9710079.
Loss of body mass, which occurs in the later stages of cystic fibrosis (CF), probably affects all body compartments. We hypothesized that loss of skeletal muscle mass would include inspiratory muscles and impair their function. To test this, we determined the effect of body mass index (BMI) and lean body mass (LBM) depletion on handgrip (HG) force and inspiratory muscle function (IMF). The maximum inspiratory pressure (MIP) and the sustained maximum inspiratory pressure (SMIP) were measured with a computerized system. The relationship of IMF and reduced BMI to survival was studied in 49 patients, and a further 25 patients were studied to define the link between IMF and LBM. LBM was assessed by anthropometry. In the survival study a BMI < 20 kg/m2 was associated with a low SMIP (p < 0.001) and reduced survival, whereas MIP was relatively preserved. In the cross-sectional study SMIP (p < 0.001), MIP (p < 0.01), and HG (p < 0.01) were all reduced in the low LBM group, but not when related to total LBM. C-reactive protein and LBM were inversely related (r = -0.71, p < 0.01). Impaired IMF was chiefly a loss of sustained muscle contraction secondary to a reduced skeletal muscle mass, which may be related to pulmonary inflammation.
体重减轻发生在囊性纤维化（CF）后期，可能影响身体所有腔室。我们推测骨骼肌质量的减少会累及吸气肌并损害其功能。为了验证这一点，我们确定了体重指数（BMI）和去脂体重（LBM）耗竭对手握力（HG）和吸气肌功能（IMF）的影响。使用计算机系统测量最大吸气压力（MIP）和持续最大吸气压力（SMIP）。在49例患者中研究了IMF降低与BMI降低和生存率的关系，并对另外25例患者进行研究以明确IMF与LBM之间的联系。通过人体测量学评估LBM。在生存研究中，BMI<20kg/m2与低SMIP（p<0.001）和生存率降低相关，而MIP相对保留。在横断面研究中，低LBM组的SMIP（p<0.001）、MIP（p<0.01）和HG（p<0.01）均降低，但与总LBM无关。C反应蛋白与LBM呈负相关（r=-0.71，p<0.01）。IMF受损主要是由于骨骼肌质量减少导致的持续肌肉收缩丧失，这可能与肺部炎症有关。
