摘要
目的 本研究通过检测受试者骨骼肌质量、骨骼肌指数、握力,推算运动代谢当量METs值来评估老年人肌肉功能情况,进而探讨共病状态对老年住院患者肌肉功能的影响.方法 选取2021年9-12月于天津市第一中心医院全科医学科住院的88例老年患者(年龄≥65岁)作为研究对象.收集患者一般资料,包括性别、年龄、入院主诉症状、疾病诊断、长期用药情况;利用生物电阻抗法测定骨骼肌质量(SMM)、骨骼肌指数(SMI)等,利用握力计测量优势手的握力来评价肌力,利用运动代谢当量METs值评价日常运动水平.评估老年患者共病状态,计算查尔森共病指数(CCI);根据肌肉质量和运动功能进行肌少症的筛查;分析研究对象的共病情况与肌少症、运动能力的相关性.结果 老年住院患者共病患病率为100.0％(88例),入院主诉症状以头部不适、心前区不适、心悸为主,肌少症患病率为10.2％(9例),且握力在不同年龄组比较差异均有统计学意义(P＜0.05).经Spearman相关分析发现,握力与CCI、年龄、体脂率均呈负相关关系(P＜0.05);METs值与年龄呈负相关关系(P＜0.05).肌少症患者肿瘤的检出率高于无肌少症患者(P＜0.001).结论 全科医学科住院的老年患者共病情况严重.随着共病状态的加重,肌肉功能下降,且在握力上表现更明显.握力的测量比骨骼肌含量和骨骼肌指数的测量更为便捷,重复性好,适合大规模的现况调查,提示握力在老年人综合评估中有重要的作用.老年女性比男性的日常运动水平高,提示在老年男性患者健康管理时更应该提醒其养成运动习惯.
Abstract
Objective To evaluate the muscle function of elderly patients by measuring their skeletal muscle mass,skel-etal muscle index,grip strength,and exercise metabolic equivalent METs values,and further explore the impact of co-morbidity on muscle function in elderly hospitalized patients.Methods Elderly patients(aged ≥ 65 years)hospitalized in the General Medicine Department of Tianjin First Central Hospital from September 2021 to December 2021 were select-ed as the study subjects.The following general information for the enrolled cases were collected:gender,age,admission symptoms,disease diagnosis,and long-term medication status.The bioelectrical impedance method was used to measure the skeletal muscle mass(SMM,kg),skeletal muscle index(SMI),etc.The grip strength of the dominant hand was measured by the grip strength meter to evaluate the muscle strength,and the exercise metabolic equivalent of task METs value was used to evaluate the daily exercise level.Comorbidity status in elderly patients was evaluated,the Charlson co-morbidity index(CCI)was calculated.Sarcopenia was screened based on muscle mass and motor function.The correla-tion between comorbidities,sarcopenia,and motor ability of the study subjects was analyzed.Results The prevalence of comorbidities in this study was 100.0％(88 cases),with the main symptoms of admission complaints being head discom-fort,precordial discomfort,and palpitations.Among the enrolled cases,the incidence of sarcopenia was 10.2％(9 ca-ses),and there was a statistically significant difference in grip strength among different age groups(P＜0.05).Spearman correlation analysis revealed a negative correlation between grip strength and CCI,age,and body fat rate(P＜0.05).The values of METs were negatively correlated with age(P＜0.05).The detection rate of tumors in patients with sarcope-nia was significantly higher than that in patients without sarcopenia(P＜0.001).Conclusion The comorbidities of eld-erly patients admitted to the general practice department are severe.As comorbidities worsen,muscle function decreases,and the performance in grip strength is more pronounced.The measurement of grip strength is more convenient and repro-ducible than the measurement of skeletal muscle content and skeletal muscle index,making it suitable for large-scale cross-sectional surveys.This suggests that grip strength plays an important role in the comprehensive evaluation of elderly people.Older women have a higher level of daily exercise than men,suggesting that we should remind older male patients to develop exercise habits when managing their health.
维普
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