老年冠心病患者肌少症发生情况与心功能的相关性研究

Prevalence of sarcopenia and its correlation with cardiac function in elderly patients with coronary heart disease

目的 调查老年冠心病患者肌少症发生情况及其与心功能的相关性。方法 选择2021年6月至2022年6月宜宾市第一人民医院住院的老年冠心病患者317例,以骨骼肌质量指数(SMI)为确诊肌少症依据分为肌少症组89例和无肌少症组228例。参考亚洲肌少症工作组标准用简易五项问卷(SARC-F)筛查+SMI确诊肌少症发生情况,分析肌少症与超声心动图指标及实验室指标的相关性。结果 老年冠心病患者SARC-F评分(2.90±1.37分)肌少症筛查阳性率为38.2%,SMI肌少症确诊阳性率为28.1%。肌少症组左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、N末端B型钠尿肽前体(NT-proBNP)和缺血修饰白蛋白(IMA)明显高于无肌少症组,心排血量、LVEF明显低于无肌少症组(P<0.01)。肌少症与心功能分级相关(r=0.182,P<0.05)。按性别分类,男性和女性老年冠心病患者SMI与心排血量和LVEF呈正相关,与LVEDD、LVESD、IVST、LVPWT、NT-proBNP和IMA呈负相关(P<0.01)。结论 老年冠心病患者肌少症患病率与年龄、共病、心功能分级和心功能指标有关,预防冠心病患者肌少症发生有利于改善心功能。

Objective To investigate the prevalence of sarcopenia and its correlation with cardiac function in elderly patients with CHD.Methods A total of 317 elderly CHD patients admitted in our hospital from June 2021 to June 2022 were recruited,and then divided into sarcopenia group(n=89)and non-sarcopenia group(n=228)according to their skeletal mass index(SMI).Based on the 5-item questionnaire(strength,assistance walking,rise from a chair,climb stairs and falls,SARC-F)established by the Asian Working Group for Sarcopenia and SMI,the correlations of sarcopenia were explored with echocardiographic and laboratory indicators.Results For the subjected elderly CHD patients,the positive rate of sarcopenia screened by SARC-F(2.90±1.37)was 38.2%,and was 28.1%by SMI.LVEDD,LVESD,IVST,LVPWT,NT-proBNP and IMA were significantly higher,while CO and LVEF were obviously lower in the sarcopenia group than the non-sarcopenia group(P<0.01).Sarcopenia was related to NYHA classification(r=0.182,P<0.05).For both male and female subjects,SMI was positively correlated with CO and LVEF,and negatively with LVEDD,LVESD,IVST,LVPWT,NT-proBNP and IMA(P<0.01).Conclusion The prevalence of sarcopenia in elderly patients with CHD is related to age,comorbidity,NYHA classification and cardiac function indicators.Prevention of sarcopenia in these patients is helpful to improve their cardiac function.