冠心病患者发生肌少症的危险因素及对心功能和短期预后的影响

Risk factors of sarcopenia and their influence on heart function and short-term prognosis in patients with coronary heart disease

目的探讨冠状动脉粥样硬化性心脏病(冠心病)患者发生肌少症的危险因素及对心功能和短期预后的影响。方法选择铜陵市中医医院于2022年1月至2023年6月就诊的120例冠心病患者作为研究对象,根据是否确诊肌少症分为肌少症组31例和非肌少症组89例。分析冠心病发生肌少症的危险因素,并比较两组患者心功能指标及随访3个月的主要不良心脑血管事件(MACCE)发生率。结果多因素Logistic回归分析显示,性别、年龄、体质指数(BMI)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、肌酐(Cr)/胱抑素C(Cys C)均是冠心病患者发生肌少症的危险因素(P<0.05);心功能指标中,肌少症组左室射血分数(LVEF)、心排血量(CO)分别为(43.29±3.86)%、(4.06±0.76)L/min,均低于非肌少症组的(48.93±3.75)%、(4.78±0.92)L/min,左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)分别为(51.23±4.26)mm、(48.26±4.68)mm,均高于非肌少症组的(47.17±3.67)mm、(45.93±4.06)mm,有统计学意义(P<0.05);肌少症组短期MACCE总发生率为19.35%,明显高于非肌少症组的5.62%(P<0.05)。结论冠心病患者发生肌少症的危险因素较多,包括性别、年龄、血脂紊乱、Cr/CysC,肌少症可进一步影响患者心功能及短期预后,临床应予以重视。

Objective To investigate the risk factors of sarcopenia and their influence on heart function and short-term prognosis in patients with coronary heart disease(CHD).Methods CHD patients(n=120)were chosen from Hospital of Chinese Medicine of Tongling City from Jan.2022 to June 2023,and divided,according to they had or not had diagnosed sarcopenia,into sarcopenia group(n=31)and non-sarcopenia group(n=89).The risk factors of sarcopenia were analyzed in CHD patients.The indexes of heart function and incidence of major adverse cardiovascular and cerebrovascular events(MACCE)after 3-month follow-up were compared between 2 groups.Results The results of multi-factor Logistic regression analysis showed that gender,age,body mass index(BMI),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),creatinine(Cr)/cystatin C(Cys C)were risk factors of sarcopenia in CHD patients(P<0.05).Among indexes of heart function,left ventricular ejection fraction(LVEF)and cardiac output(CO)were lower in sarcopenia group than those in non-sarcopenia group[(43.29±3.86)%vs.(48.93±3.75)%;(4.06±0.76)L/min vs.(4.78±0.92)L/min],and left ventricular enddiastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)were higher in sarcopenia group than those in non-sarcopenia group[(51.23±4.26)mm vs.(47.17±3.67)mm;(48.26±4.68)mm vs.(45.93±4.06)mm,P<0.05].The total short-term incidence of MACCE was 19.35%in sarcopenia group and 5.62%in nonsarcopenia group(P<0.05).Conclusion There are many risk factors for sarcopenia occurrence,including gender,age,dyslipidemia,Cr/CysC,and sarcopenia will further affect heart function and short-term prognosis in CHD patients,which should be paid attention to clinically.