老年维持性血液透析肌少症患者药物治疗的研究进展

Research Progress of Drug Treatment in Elderly Patients with Sarcopenia in Maintenance Hemodialysis

肌肉减少症(sarcopenia),简称肌少症,是一种与年龄有关且对生活质量有着重大影响的退化性疾病,骨骼肌肌肉质量、力量的不自主退行性病变及功能障碍是其特征。除了与年龄相关外,长期卧床缺乏体力锻炼、慢性疾病及恶性肿瘤的消耗、营养不良、维生素D缺乏等多种因素均可促使其发生,随之患者跌倒和残疾的风险增高,独立生活的能力减退,直接影响生活质量和临床结果。在过去的几十年里,老年血液透析患者越来越多,而透析患者食欲差,营养摄入少,使得肌少症患病率更高。因此,血液透析患者肌少症的早期识别及干预对于延缓衰弱,提高生活质量及改善预后有重要意义。目前肌少症缺乏特效药,防治该病的措施主要是运动疗法和营养疗法,但药物治疗是继运动锻炼和补充蛋白质之后的最有效措施,且有很大的发展前景。本文主要对老年维持性血液透析肌少症患者药物治疗的研究进展进行综述。

Sarcopenia is a degenerative disease with age that has a significant impact on quality of live,characterized by involuntary degeneration and dysfunction of skeletal muscle mass and strength.It is multiple factors,in addition to the age-related,stay in bed for lack of physical exercise for a long time,the consumption of chronic disease and malignant tumor,malnutrition,lack of vitamin D can make it happen,and patient falls,weakness and higher risk of disability,decreased ability to live independently,directly affects the patients’ quality of life and clinical results.In the past few decades,the number of elderly hemodialysis patients has increased,and dialysis patients have poor appetite and low nutritional intake,resulting in a higher incidence of sarcopenia.Therefore,early identification and intervention is of great significance for delaying fattening,improving quality of life and improving prognosis of hemodialysis patients.At present,there is a lack of specific drugs for sarcopenia.The main measures to prevent and treat sarcopenia are exercise therapy and nutrition therapy,but drug therapy is the most effective measure after exercise and protein supplement,and has a great prospect of development.This article mainly reviews the research progress of drug therapy for senile maintenance hemodialysis patients with sarcopenia.