慢性阻塞性肺疾病与肌肉减少症

Chronic obstructive pulmonary disease and Sarcopenia

肌肉减少症与慢性疾病有关,如慢性心力衰竭、2型糖尿病、慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)等。COPD的特点是不可逆的气流受限,随着病情的进展,呼吸困难会加剧。据报道,稳定期COPD中肌肉减少症的患病率为15%~25%。随着体力活动的减少,机体肌肉质量逐渐下降,导致体内氧气无法有效利用,从而运动能力下降的恶性循环。由于体力活动减少导致的功能失调是COPD患者肌肉功能障碍的主要原因。降低肌肉力量和耐力的因素包括氧化应激、慢性炎症、缺乏运动、低氧血症、维生素D和蛋白质缺乏、激素异常,以及使用全身性皮质类固醇等。治疗方法包括营养支持、运动治疗、营养补充剂和药物等。肌肉减少症和COPD之间的关系越来越被关注,在临床特征和治疗方面有一些重叠。因此,本文旨在综述慢性阻塞性肺疾病与肌肉减少症这两种疾病的临床相关性和综合治疗方法。

Sarcopenia is related to chronic diseases,such as type 2 diabetes,chronic heart failure,chronic obstructive pulmonary disease(COPD),etc.The characteristic of COPD is irreversible airflow restriction,which exacerbates breathing difficulties as the disease progresses.It is reported that the prevalence of Sarcopenia in sta-ble COPD is 15%~25%.As the amount of activity decreases,muscle mass declines,and ultimately,oxygen cannot be effectively utilized,leading to a vicious cycle of decreased exercise ability.Dysfunction caused by reduced ac-tivity is the leading cause of limb muscle dysfunction in COPD patients.Factors that reduce muscle strength and endurance include oxidative stress,chronic inflammation,lack of exercise,hypoxemia,hormone abnormalities,pro-tein and vitamin D deficiency,and the use of systemic Corticosteroids.Therefore,treatment methods include train-ing,nutritional support,medication,and supplements.The relationship between COPD and Sarcopenia has attract-ed more and more attention,with some overlap in clinical features and treatment.Therefore,this article reviews these two diseasesclinical correlation and comprehensive treatment methods.