稳定期慢性阻塞性肺疾病患者握力水平与四肢瘦组织质量的相关性研究

Relationship between handgrip strength and appendicular lean mass in patients with stable chronic obstructive pulmonary disease

目的慢性阻塞性肺疾病(COPD)患者握力水平与四肢瘦组织质量(ALM)的关系还未进行深入的探讨。方法选取2016年8月至2017年7月于苏州大学附属第一医院呼吸科门诊就诊的93例稳定期COPD患者。对所有患者进行握力测试、身体成分分析,分析握力水平与ALM间的关系。结果多元回归分析结果显示,年龄(X1)、文化程度(X2)、吸烟史(X3)、病程(X4)及下肢瘦组织质量(X5)共5个因子可解释握力水平50.5%的变异程度,多元线性回归方程为Y=9.959-4.351X1+1.397X2+2.679X3-1.526X4+1.538X5。将病程从模型中移除,变异程度减至48.1%;将下肢瘦组织质量移除,减至28.3%;同时移除两变量,则减至26.5%。ALM、上肢、下肢、躯干瘦组织质量分别为(22.32±3.25)、(6.48±1.05)、(15.83±2.26)及(22.27±3.22)kg,与握力水平[(32.27±7.27)kgf]相关系数分别为:0.486、0.436、0.496及0.496(P<0.01)。结论稳定期COPD患者握力水平与ALM密切相关,且病程及下肢瘦组织质量极大影响患者握力水平。

Objective At present no deep investigation has been done on the relationship between handgrip strength and appendicular lean mass(ALM)in patients with chronic obstructive pulmonary disease(COPD).The study aimed to explore the present situation of handgrip strength in patients with stable COPD and relationship between handgrip strength and ALM. Methods A total of 93 patients with stable COPD who hospitalized in our department from August 2016 to July 2017 were selected for the study.All the patients underwent handgrip strength test,body composition analysis,as well as the analysis of the relationship between handgrip strength and ALM. Results Multivariate linear regression analysis showed age(X 1),education(X 2),smoking(X 3),course of disease(X 4)and lower limb lean mass(X 5)could be taken as predictive factors for the variation degree of handgrip strength(R 2=50.5%),and multiple linear regression equation was Y=9.959-4.315 X 1+1.397X 2+2.679X 3-1.526X 4+1.538X 5.The variation degree decreased to 48.1%when the course of disease was removed from the model,28.3%when the limb lean mass was removed,26.5%when two variables were removed.The correlation coefficients of ALM,upper limb,lower limb and torso lean mass([22.32±3.25]kg,[6.48±1.05]kg,[15.83±2.26]kg,[22.27±3.22]kg)with handgrip strength([32.27±7.27]kgf)were respectively 0.484,0.436,0.496 and 0.496(P<0.01). Conclusion The handgrip strength in patients with stable COPD is closely associated with ALM,and the course of disease and the lower limb lean mass greatly affect the handgrip strength.Clinical workers should pay extra attention to the relationship in order to give timely clinical intervention.