老年男性肌少症严重程度与肺功能及活动耐量的相关性探讨

The Correlations of Sarcopenia Severity with Pulmonary Function and Exercise Tolerance in Elderly Males

目的通过比较老年男性肌肉减少症(肌少症)中的肺功能及活动耐量水平差异,明确肌肉减少症的严重程度与肺功能减退及慢性阻塞性肺疾病(COPD)的相关性,通过检测血清炎症细胞因子水平,评价其在预测肺功能及活动耐量下降程度中的价值。方法研究2018年8月—2019年5月复旦大学附属华东医院收治的≥60岁患有肌少症男性住院患者共46例。所有入组患者接受肺功能检测,活动耐量评估和血清炎症因子及相关指标检测。结果46例患者平均四肢骨骼肌指数(SMI)值为(5.74±0.74)kg/m^2、平均CAT评分(16.20±10.51)分、m MRC均值为(2.09±1.49)、平均IL-6水平为(5.60±5.72)ng/L、平均BMC为(2418.97±519.11)g;相关分析发现,患者SMI值与肺功能指标(FEV1/FVC以及FEV1)、CAT评分、m MRC值、IL-6及BMC值存在相关性,P<0.01;FEV1与IL-8水平亦呈负相关,P=0.032;线性回归分析发现,CAT、IL-8、SMI指标与FEV1之间存在相关(R=0.841,P<0.05),CAT评分、IL-8与FEV1呈负相关(P<0.05),SMI与FEV1呈正相关(P<0.05)。结论在老年肌少症男性患者中,四肢骨骼肌指数(SMI)与肺功能指标(FEV1/FVC以及FEV1)、生活质量评分(CAT及mMRC)及炎症因子(IL-6)呈高度相关。低骨骼肌指数可作为筛查阻塞性气流受限人群的有效指标,在评价肺功能及生活质量下降严重程度以及判断患者预后中具有一定的临床价值。

Objective To investigate the correlation of sarcopenia severity with insufficiency of pulmonary function and COPD and the value of serum inflammatory indicators in predicating the decrease of pulmonary function and exercise tolerance.Methods 46 elderly males with sarcopenia aged over 60 years during the period from August,2018 to May,2019 were given pulmonary function test,exercise tolerance assessment and detection of serum inflammatory cytokine and related indicators.Results The mean skeletal muscle index(SMI)of all the cases was(5.74±0.74)kg/m^2,the average COPD Assessment Test(CAT)score was(16.20±10.51),the mean mMRC was(2.09±1.49),the mean IL-6 was(5.60±5.72)ng/L and the mean BMC was(2418.97±519.11)g;Correlation Analysis indicated that SMI of extremities was correlated with pulmonary function indexes(FEV1/FVC and FEV1),CAT,m MRC,IL-6 and BMC(P<0.01),and FEV1 was negatively correlated with IL-8(R=0.032);Linear Regression Analysis indicated the indexes of CAT,IL-8 and SMI were of certain correlation with FEV1(R=0.841,<0.05),CAT score,IL-8 level showed a negative correlation with FEV1 while SMI showed a positive correlation with FEV1(P<0.05).Conclusions The SMI of extremity is highly correlated with the pulmonary function index(FEV1/FVC and FEV1),the scores of life quality(CAT and m MRC)and the inflammatory indicators(IL-6)in elderly males with sarcopenia;low SMI can be taken as effective indicator in screening people with obstructive airflow restriction,which is of certain value in evaluating pulmonary function and the decline of life quality and in predicating the prognosis.