维持性血液透析病人捏力及握力与肌肉质量的相关性研究

A study of correlation between pinch and grip strength and muscle mass in maintenance hemodialysis patients

目的:探讨MHD病人捏力及握力与肌肉质量之间的关系。方法:纳入2021年3月在广州市红十字会医院血液透析中心行MHD的病人。测量其透析前的捏力、握力,采用人体成分分析仪测量其瘦体质量、人体细胞质量等身体成分,并收集病人的身高、体质量、上臂肌围等人体测量数据以及透析前血液生化指标。根据握力的性别特异性分组,比较两组病人的临床特征。通过Spearman或Pearson、多元线性回归等方法分析MHD病人的捏力、握力与肌肉质量及生化指标间的相关性。结果:共纳入MHD病人140例。与正常握力组(n=28)比较,低握力组(n=112)的病人年龄较大,血清肌酐、白蛋白、前白蛋白、铜蓝蛋白、PS、小腿围、瘦体质量、BCM、mCI均更低,而CRP、IL-6、BF%、7分SGA≤及GNRI<91.2的营养风险均更高(P<0.05)。多变量后退线性回归模型显示较高的捏力值与较高的肌酐、瘦体质量和骨骼肌质量及较低的白介素-6独立相关,较高的握力数值与较高的血清肌酐和瘦体质量及较低的年龄、白介素-6独立相关(P<0.05)。结论:在MHD病人中,捏力、握力与生物电阻频谱分析测量的瘦体质量、人体细胞质量、骨骼肌肉群呈正相关关系,提示捏力及握力均可作为评价MHD病人肌肉功能的一个良好指标。

Objective:To investigate the relationship between pinch strength(PS),and handgrip strength(HGS) and muscle mass in maintenance hemodialysis(MHD)patients.Methods:Patients who underwent MHD in March 2021 in the hemodialysis center of Guangzhou Red Cross Hospital were included..Their PS and HGS were measured before dialysis.Multi-frequency body composition analyzer was used to measure the lean,body cell mass(BCM)and other body components,and the anthropometric data such as the height,weight,mid-arm muscle circumference and laboratory parameters before dialysis were collected.Sex-specific groupings based on grip strength were used to compare the clinical characteristics of the two groups of patients..The correlations between pinch strength,grip strength and muscle mass and biochemical indexes of MHD patients were analyzed by Spearman or Pearson and multiple linear regression..Results:A total of 140 MHD patients were included.Compared with the normal grip strength group(n=28),patients in the low grip strength group(n=112)were older and had lower serum creatinine,albumin,prealbumin,cuprocyanin,PS,calf circumference,lean body mass,BCM,and mCI,while the nutritional risk was higher for CRP,IL-6,BF%,7-point SGA≤,and GNRI<91.2(P<0.05).Multivariate backward linear regression modeling showed that higher pinch strength values were independently associated with higher creatinine,lean body mass and skeletal muscle mass and lower interleukin-6,and higher grip strength values were independently associated with higher serum creatinine and lean body mass and lower age and interleukin-6(P<0.05).Conclusion:In MHD patients,HGS and PS were positively correlated with lean,BCM,SMM as measured by bioelectrical impedance analysis,suggesting that both PS and HGS can be as a good indicator for evaluating muscle function in MHD patients.