Appendicular Mucocele with Robotic Partial Typhlectomy and Correction of Rectus Abdominal Muscles’ Diastasis: A Case Report

Low-grade appendiceal mucinous neoplasm (LAMN) is rare, and patients are often asymptomatic or have nonspecific symptoms. Appendicectomy should be performed with care and limited handling of the appendix, with extraction of the specimen through an extraction bag to prevent perforation and spillage of mucin, which can result in the development of pseudomyxoma peritonei (PMP). This case report aims to shed light on the approach to appendicular mucocele in contemporary medicine. The reported case shows a presentation of mucocele in a young female patient with symptoms compatible with appendicitis. This case report serves as an example of how to diagnose, manage, and follow-up on appendicular mucocele treatment for colleagues who may encounter similar conditions.

Appendicular Mucocele: About a Case Observed in Bamako

It is a globally rare condition that can present in a variety of clinical syndromes or can occur as an incidental surgical finding. It poses the double problem of its possible malignancy and the risk of gelatinous disease of the peritoneum in the event of perforation. We report a case treated in the “A” Surgery Department of the Point-G University Hospital Center (CHU) in Mali in 2022. It was a 62-year-old woman, a housewife who presented to the department. “A” surgery at the Point G University Hospital Center for pain in the iliac fossa. As a medical history, she was hypertensive on atenolol and a known diabetic on diet and metformin-based treatment, as well as symptomatic sickle cell disease (AS) and an undocumented history of peptic ulcer disease. The biological assessments revealed hyperleukocyte with granulocyte predominance. C-reactive protein was positive at 32 mg/l. Ultrasound revealed a 27 mm cystic dilation of the appendicitis in favor of appendicular mucocele. We proceeded with the appendix. The surgical specimen containing gelatinous fluid was removed and histological examination was in favor of a mucinous adenocarcinoma of the appendix.

Appendicular Mucosal Tube Implant with Dartos Wrap Operation for Hypospadias

Aims and Objective: To develop a better operation for hypospadias patients with poor and bad quality urethral plate and damaged urethral plate as in hypospadias cripples. Materials and Methods: I operated 21 cases of hypospadias with Appendicular mucosal tube implant with Dartos wrap operation from 17/04/2017 to 03/03/2019, in Jawale Institute of pediatric Surgery, and that group was labeled as group A. 27 cases of hypospadias were operated in same time span with conventional techniques such as extended Snodgrass operation and Byar’s two-stage operation (group B), kept as control. 7 patients (33.33%) were cases of hypospadias cripples with multiple surgeries done in the past. 4 patients (9.52%) patients had congenital short urethra. Remaining 10 patients (50%) were fresh cases with no operation done in past but with bad and fibrotic urethral plate. The longest follow up was 3 years and the shortest of 1 year. Technique of Operation: Appendicectomy performed by open technique and the serosa of Appendix cut longitudinally and stripped off the mucosal tube. The proximal hypospadias opening sutured with the appendicular mucosal tube with 6 sutures of 5-0 Vicryl. Dartos fascia is raised from the scrotum wrapped over the tube and 8 - 10 interrupted stitches taken with 5-0 Vicryl. Glanuloplasty performed over it. Suprapubic diversion did and kept for 3 weeks postoperatively. Results: In group A, 3 patients developed fistula and only 1 (4.76%) required repair at the end of 6 weeks. 2 (9.52%) patients developed grade 3 infection and settled with conservative treatment. UFR was normal at the end of 12 weeks (12.85 Ml/sec. In group B, 11 patients developed fistula and 9 (33.33%) required repaired. 9 (33.33%) patients developed strictures and all of them required multiple urethral dilatation under GA. 7 (25.92%) patients developed meatal stenosis.UFR was badly reduced with average of 5.78 ML/Sec. Conclusion: The operation proves to be a much better option compared to the conventional for group A patients. We need a series with longer follow up and larger number of patients.

Appendicular Abscess in the Service of General Surgery at the Teaching Hospital Gabriel Toure, Bamako, Mali

Objectives: To determine hospital frequency and to write the diagnostic and therapeutic aspects of appendicular abscess in adults in the General Surgery Department of teaching Hospital Gabriel Touré from 2005 to 2017. Material and Methods: This was a retrospective study conducted from January 1, 2005 to December 31, 2017 in the General Surgery De-partment of Gabriel Touré University Hospital in all patients with appen-dicular abscess. Results: In 13 years, 1420 cases of acute appendicitis have been reported, including 105 cases of appendicular abscess (7.4%). Mean age of the patients was 32 years with extremes of 16 years and 70 years. Abdominal pain and fever were present in all patients. Pain sat in the right iliac fossa in 73.3% and was epigastric in 11.4%. In almost all cases abdominal defense was present (97.1%). There was generalized abdominal contracture in 2.8% of cases. Average duration of evolution was 27 days with extremes of 1 day and 60 days. Ultrasonography was performed in 42.6% of cases and found peri-appendicular effusion in 29 cases (27.6%). 90 incisions were made by incision of Mac Burney, 8 by median umbilical, 7 by midline above and below umbilical. The amount of fluid aspirated was greater than 100 cc in 47 patients. We performed an appendectomy with appendicular stump burying followed by washing plus drainage of the abdominal cavity in 65 patients. Morbidity rate was 14.3%. No deaths were recorded. Average duration of hospitalization was 6.5 days with extremes of 2 days and 26 days.

Appendicular Abscess in General Surgery at the Bocar Sidi Sall University Hospital in Kati

Introduction: Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting in the formation of a true septate abscess of the large peritoneal cavity. Materials and Methods: This was a retrospective study from January 2010 to December 2019 carried out at the Bocar Sidi Sall University Hospital in Kati (CHU BSS in Kati) in general surgery. It concerned all patients operated on for appendicular abscess in the department. Results: 75 cases of appendicular abscess were collected, which represented 5.76% of surgical emergencies and 25% of acute appendicitis. The average age of the patients was 29 years. The male sex represented 67% of our patients with a sex ratio of 2. The average consultation time was 5 days. Abdominal pain was noted in all patients. It was localized in the right iliac fossa in 80% (n = 60) and diffuse in 2.7% of cases (n = 2). It was accompanied by nausea and vomiting in 93% of cases (n = 70), urinary disorders in 20% (n = 15), fever in 94% (n = 71), cessation of materials and gas in 1.33% (n = 1). Abdominal ultrasound was performed in 86% (n = 65). It made it possible to suggest a peri-appendicular effusion. Biological examination revealed a neutrophilic hyperleukocytosis greater than 20,000/mm3 in 47 patients, or 63%. All the patients were operated on by laparotomy (Marc Burney or midline subumbilical) under general anesthesia. The length of hospitalization was 6 days. We have not recorded any deaths. Morbidity was 8% (n = 6) represented by parietal suppuration. The postoperative course was straightforward in 92% of cases (n = 69). Conclusion: Appendicular abscess is a frequent medico-surgical emergency, the prognosis of which depends greatly on early diagnosis and adequate and immediate management.

Peritonitis Management through Appendicular Perforation in the Department of Surgery Bougouni Hospital (Mali)

Introduction: Appendicular peritonitis is a complication of acute appendicitis characterized by the spread of the infectious process in the peritoneal cavity thus achieving wide spread or localized purulent peritonitis;it’s a medico-surgical emergency. Our objectives are to determine the frequency, describe the clinical, therapeutic and prognostic aspects of peritonitis by appendicular perforations. Patients-Method: This was a 24-month retro, prospective, descriptive study from January 1, 2018 to December 31, 2019;conducted in the Bougouni Reference Health Center Surgery Unit. All patients of appendicular peritonitis at the Bougouni Reference Health Centre were included. Results: During the study period, 68 cases of generalized acute peritonitis including 30 appendicular peritonitis cases were collected. Appendicular peritonitis accounted for 44.1% of surgical procedures. Males accounted for 71.0% with a sex ratio of 1.2 at risk of men, the average age was 26.07 years. Abdominal pain and vomiting were the reasons for consultation in 86.7% and 76.7% of cases. Physical examination was used in most cases to make the diagnosis. X-ray of the abdomen without preparation, and abdominal ultrasound were performed systematically. Surgical treatment consisted of an appendectomy with peritoneal toilet followed by drainage. The average length of hospitalization was 8.8 days with extremes of 1 - 44 days. Hospital mortality was 3.3%;morbidity and high mortality were related to delayed consultation. Conclusion: Appendicular generalized acute peritonitis is a medical-surgical emergency with a high mortality rate associated with delayed management.

Appendicular Abscess: Unusual Clinico-Radiological Appearance

Introduction: Appendicitis is the most common surgical emergency in childhood. It’s a common surgical disease that can be presented with a wide variety of atypical clinical features. Clinical Case: We report a case of a 7-year-old female patient admitted for abdominal pain dating back 20 days, radiological exploration suggested a right ovarian teratoma, while laparoscopic exploration has objective an appendicular abscess. Conclusion: This case has allowed us to clarify an atypical case of complicated appendicitis, and also to show the contribution of laparoscopy.

Appendicular Peritonitis in the General Surgery Department of Gabriel TOURE CHU

The appendicular peritonitis is complications of acute appendicitis which are characterized by the diffusion of the infectious process to the peritoneal cavity thus carrying out a generalized or located purulent peritonitis. It can appear from the start or follow the stage of appendicular abscess. Our objectives were to determine the frequency, to describe the clinic and para clinic aspects, to identify the principal germs and their sensitivities to antibiotics and to describe the operative continuations. Our prospective and descriptive study focused on patients treated for appendicular peritonitis, from January 1st to December 31st 2016, in the General Surgery Department of the Hospital of Sikasso. During the period of our study, 31 cases of appendicular peritonitis were collected, which represented 4.36% of surgical interventions, 19.25% of urgent surgeries. The male sex accounted for 71.0% with a sex-ratio of 2.44 at the risk of males, the average age was of 20 years ± 12.99, the abdominal pain + vomiting was the reason for consultation in 54.8% of cases. The physical examination allowed in most cases to make the diagnosis. In doubtful cases some additional examinations have been requested (abdomen without preparation, abdominal ultrasound). The surgical treatment consisted of an appendectomy with peritoneal lavage followed by drainage. The average length of hospital stay was 8.8 days with extremes of 1 - 44 days. Hospital mortality was 9.7%. Delay in consultation and age were factors of morbidity and high mortality.

骨骼肌质量和肌肉力量对缺血性脑卒中患者神经功能的预测效能评价

目的 探讨并评价缺血性脑卒中患者骨骼肌质量和肌肉力量对脑卒中后3个月神经功能预后的预测效能。方法 纳入117例缺血性脑卒中患者,根据脑卒中后3个月的改良Rankin量表(mRS)评分分为预后不良组(54例)和预后良好组(63例),比较两组骨骼肌质量、肌肉力量等相关指标的差异。采用Pearson相关分析骨骼肌质量、肌肉力量与mRS评分之间的相关性,采用logistic回归分析ASM/Ht2、握力与神经功能预后之间的关系,同时应用受试者工作特征(ROC)曲线评估其对神经功能预后的预测效能。结果 与预后良好组相比,预后不良组年龄均数较大、国立卫生研究院脑卒中量表(NIHSS)评分均数较高,合并低肌肉质量的患者比例、合并低肌肉力量的患者比例以及同时合并低肌肉质量与低肌肉力量的患者比例均较高;而ASM/Ht2和握力均数则较低,差异均有统计学意义(t分别=3.55、4.94,χ^(2)分别=7.27、20.35、11.51,t分别=-4.40、-9.56,P均<0.05)。ASM/Ht2、握力与mRS评分呈负相关(r分别=-0.56、-0.74,P均<0.05)。多因素logistic回归分析发现,ASM/Ht2和握力大是神经功能预后不良发生的保护因素(OR分别=0.64、0.54,P均<0.05)。ROC分析显示,握力的曲线下面积(AUC)为0.89,明显大于ASM/Ht2的AUC(0.71),差异有统计学意义(Z=3.05,P<0.05)。结论 脑卒中患者发病早期的骨骼肌质量和肌肉力量均与其康复期神经功能不良预后密切相关。骨骼肌质量和肌肉力量对脑卒中患者神经功能预后均具有较好的预测价值,尤其是握力,其预测效能更优。

Mohs显微描记手术治疗小汗腺汗孔癌一例

患者,男,56岁。左颞部肿物4年余,切除后复发半年。组织病理示:真皮内肿瘤团块,部分伴中央片状坏死。免疫组化示:肿瘤细胞CK5/6阳性,瘤团坏死周边瘤细胞EMA阳性。诊断为小汗腺汗孔癌。Mohs显微手术切除及全厚皮片移植术后恢复良好,随访18个月无复发。

生物电阻抗法测量18~42岁成人四肢骨骼肌质量的准确性评价

目的评价生物电阻抗法(bioelectrical impedance analysis,BIA)测量成人四肢骨骼肌质量(appendicular skeletal muscle mass,ASM)的准确性。方法采用方便抽样法,于2021年4月至2022年9月在广州全市招募836名18~42岁成人,采用BIA与双能X线吸收法(dual-energy X-ray absorptiometry,DXA)同步检测ASM。以DXA为标准方法,通过组内相关系数以及在对数变换数据中进行Bland-Altman分析判断BIA与DXA所测值的一致性,以此评价BIA测量ASM的准确性。绘制受试者工作特征曲线,评价BIA识别低肌肉质量的诊断价值。结果最终纳入774名研究对象。男、女性中两法所测ASM组内相关系数分别为0.774和0.667。男、女性中BIA与DXA所测ASM比值均值(一致性限)分别为0.94(0.80~1.10)和0.91(0.78~1.05)。BIA识别男、女性低肌肉质量的曲线下面积分别0.91和0.94。BIA判断男、女性低肌肉质量的Z值最佳界值分别为-0.57和-0.66,男性中BIA识别低肌肉质量的灵敏度、特异度分别为82.5%、86.0%,女性中分别为86.8%、93.8%。结论BIA与DXA所测成人四肢骨骼肌质量的一致性尚可,且BIA识别18~42岁成人低肌肉质量的诊断价值较好。

中老年男性肌肉减少症与骨质疏松性骨折的相关性分析

目的 探讨中老年男性肌肉减少症(SP)与骨质疏松症性骨折(OF)的相关性。方法 选取2020年2月至2023年2月中老年(50~70岁)男性骨质疏松症(OP)患者85例,其中OF 64例,非骨质疏松性骨折(NOF)21例。选取同期、同年龄段体检中心体检的非骨质疏松症患者(NOP)110例作为对照组。采用双能X线吸收骨密度仪(DXA)测量四肢骨骼肌肌肉量(ASM),计算出四肢骨骼肌指数(ASMI),观察6 m步行速度。分析中老年男性SP与OF的相关性。结果 OF组患者中SP患病率(71.88%)高于NOF组(61.90%),且高于NOP组(15.45%)。SP组患者中,OP患病率(77.63%)高于NOP组(22.37%),其中OF患病率(77.97%)亦高于NOF组(22.03%)。OP组患者ASM、ASMI、步行速度低于NOP组,其中OF组患者ASM、ASMI、步行速度低于NOF组,差异均有统计学意义(P<0.05)。多因素分析显示,ASMI是OF的独立危险因素。结论 中老年男性SP患者易发生OP,且更易发生OF,预防OF对提高患者的生活质量,降低家庭和社会的经济负担有重要意义。

绝经后女性肌少症与颈动脉斑块发生风险的关系

目的:探讨绝经后女性肌少症与颈动脉斑块发生风险的相关性。方法:采用整群抽样法,选取2022年3月—10月在华东疗养院体检中心进行健康体检的绝经后女性527例为研究对象。采用人体成分分析仪(InBody720)检测人体四肢骨骼肌质量,计算四肢骨骼肌指数(ASMI)并测量握力与步速。收集一般资料及实验室指标,采用多因素Logistic回归分析探讨绝经后女性肌少症与颈动脉斑块发生风险的关系,并采用受试者工作特征(ROC)曲线探讨ASMI对颈动脉斑块发生的预测价值。结果:527例绝经后女性中,172例发生颈动脉斑块,发生率为32.6%。绝经后女性颈动脉斑块组ASMI低于非颈动脉斑块组[5.42(4.88,6.09)kg/m^(2)与6.63(5.73,7.78)kg/m^(2),P<0.001],同时颈动脉斑块组肌少症发生率显著高于非颈动脉斑块组(45.30%与18.00%,P<0.001)。绝经后女性ASMI越小,颈动脉斑块发生风险越高(Pfor trend<0.001)。多因素Logistic回归分析显示,肌少症增加绝经后女性颈动脉斑块发生风险[OR=3.486,95%CI(2.237,5.432)]。ROC分析显示,相比于腰围及体质指数,ASMI对颈动脉斑块有更高的预测价值(ROC曲线下面积=0.756)。结论:绝经后女性肌少症增加其颈动脉斑块发生风险,ASMI可作为预测其颈动脉斑块发生的简易指标。

老年人肌少症患病情况调查及其与老年衰弱综合征的相关性分析

目的调查成都市成华区某社区老年人肌少症患病情况并分析其与老年衰弱综合征的关系。方法选取成都市成华区某社区586例老年人为研究对象,对其进行老年综合评估,包括一般资料调查、人体测量(身高、体质量、握力、步速、骨骼肌等)和衰弱筛查量表调查。评估肌少症及老年衰弱综合征发生情况,分析肌少症与老年衰弱综合征的关系。结果83例被诊断为肌少症,肌少症患病率为14.98%。肌少症组与正常组的性别、受教育程度、吸烟、饮酒及基础疾病情况比较,差异均无统计学意义(P>0.05)。与正常组相比,肌少症组年龄60~74岁者比率更低,75~84岁及≥85岁者比率更高,老年衰弱综合征发生率更高,差异有统计学意义(P<0.05)。与正常组比较,肌少症组的握力、步速、四肢骨骼肌量及四肢骨骼肌指数(ASMI)更低,差异有统计学意义(P<0.05)。多因素分析显示,年龄、体质量指数(BMI)、老年衰弱综合征均是肌少症的影响因素(P<0.05)。结论成都市成华区某社区老年人肌少症的患病率较高,肌少症与老年衰弱综合征的发生密切相关。

Long-term disease-free survival in a dog with appendicular osteosarcoma

Postoperative prognosis is generally poor even with adjuvant chemotherapy in dogs with an appendicular osteosarcoma. The purpose of this report was to present the long-term disease-free survival time in a dog with appendicular osteosarcoma receiving amputation,adjuvant chemotherapy and adoptive immunotherapy. A 12-year-old spayed Golden retriever was referred to our hospital with a suspicion of osteosarcoma in right distal radius. The patient underwent the computed tomography (CT) and incisional biopsy on the next day after the first presentation. The CT revealed the osteolysis in the right distal radius and no metastases in the lungs and lymph nodes. The histopathologic diagnosis was made as an osteosarcoma. On the 13th day after,the patient underwent right forelimb amputation. Six doses of carboplatin (250 mg / m2) were postoperatively administered every 3 weeks. The intravenous infusion of lymphokine-activated killer (LAK) cells suspension was performed every 3 ~ 4 weeks after the adjuvant chemotherapy. At the time of our writing this abstract (on the 880thday after the first presentation),no recurrences and metastases were observed after the 32 transfers of LAK cells. In canine appendicular osteosarcoma,some reports have described that postoperative median survival times were 235 ~ 540 d with adjuvant chemotherapy. In our report,the disease free interval and survival time were prolonged compared with the previous reports. We strongly believed that early diagnosis and surgical intervention and adoptive immunotherapy had a great impact on the improvement of survival time in canine appendicular osteosarcoma.

小腿围筛查稳定期男性COPD患者骨骼肌消耗研究

目的探讨小腿围筛查稳定期男性COPD患者骨骼肌消耗的效果,为早期识别骨骼肌消耗高危患者提供参考。方法对116例门诊就诊的稳定期男性COPD患者进行小腿围测量,并采用生物电阻抗法评价患者的骨骼肌消耗情况。采用ROC曲线下面积确定小腿围的最佳截点值。结果6.90%的男性COPD患者有骨骼肌消耗;116例COPD患者小腿围(34.58±3.03)cm,小腿围与四肢骨骼肌质量、四肢骨骼肌质量指数呈显著正相关(均P<0.05)。小腿围预测稳定期男性COPD患者骨骼肌消耗的最佳截点值为31.8 cm(灵敏度1.000、特异度0.861、ROC曲线下面积0.963),经调整年龄后,ROC曲线下面积提高为0.973。结论小腿围可作为稳定期男性COPD患者骨骼肌消耗筛查的有效方法。

Depression and sarcopenia-related traits:A Mendelian randomization study

BACKGROUND Observational studies have suggested that depression is associated with sarcopenia.However,the causal relationship between depression and sarcopenia remains unclear.AIM To investigate the causal relationship between depression and sarcopenia.METHODS We performed a Mendelian randomization(MR)analysis to identify the bidirectional relationship between depression and sarcopenia-related traits.Summarylevel data and independent variants used as instrumental variables came from large genome-wide association studies of depression(414055 cases and 892299 controls),of appendicular lean mass(ALM,450243 participants),and of hand grip strength(exposure:360000 participants;outcome:334925 participants).RESULTS We identified a negative association of depression with lower ALM[odds ratio(OR):0.932,95%confidence interval(95%CI):0.889-0.979,P=0.005].In the reverse MR analysis,we also observed an inverse association of hand grip strength with depression(OR:0.200,95%CI:0.108-0.370,P<0.001).Similar results were obtained in sensitivity analyses.CONCLUSION Depression was causally related to decreased muscle mass,and declined muscle strength might lead to a higher risk of depression.

军曹鱼仔稚鱼脊柱和附肢骨骼的发育特征

为探明军曹鱼仔稚鱼早期脊柱及附肢骨骼的发育特征,本研究采用软骨-硬骨双染色技术,分别利用阿利新兰、茜素红对软骨、硬骨以及1~33日龄军曹鱼仔稚鱼全骨骼进行染色,系统观察并描述其脊柱和附肢骨骼的发育特征。结果显示,军曹鱼脊柱开始发育的标志为7日龄仔鱼中脉弓和神经弓的出现;13日龄稚鱼椎骨、神经弓和脉弓开始骨化;背肋、腹肋分别于17、20日龄开始骨化;29日龄稚鱼脊柱骨化完成。附肢骨骼骨化起始顺序依次为胸鳍、尾鳍、腹鳍、背鳍和臀鳍。胸鳍匙骨于4日龄出现,肩胛骨孔于12日龄出现,同时上匙骨开始骨化;乌喙骨与肩胛骨于20日龄开始骨化;第1尾下骨于5日龄出现,15日龄稚鱼尾杆骨、侧尾下骨和尾鳍鳍条开始骨化,18日龄稚鱼尾下骨开始骨化;腹鳍支鳍骨于17日龄延伸至匙骨,同时腹鳍开始骨化;臀鳍和背鳍于17日龄由前向后开始骨化。研究表明,军曹鱼在13日龄进入稚鱼期,早期发育阶段的骨骼发育特征与其功能性适应密切相关。本研究结果对研究军曹鱼早期骨骼发育与功能适应、优化养殖条件有重要作用。

社区老年人骨骼肌质量指数与TG/HDL-C的相关性研究

目的研究社区老年人四肢骨骼肌质量指数(appendicular skeletal muscle index,ASMI)和血清TG与HDL-C比值(TG/HDL-C)的相关性。方法收集健康体检老年受试者(年龄≥65岁)中符合纳入标准且相关临床资料齐全者共192例,整理受试者的基线资料、血液学指标,将体检当天受试者通过人体成分分析仪测得的ASMI按照三分位法分为3组:<8.41为低分位组(n=64),8.41~9.16为中分位组(n=64),>9.16为高分位组(n=64)。比较3组的基线资料、生化指标和人体成分指标水平,并通过Spearman相关分析研究ASMI与相关变量之间的相关性,采用多因素Logistic回归分析ASMI的影响因素。结果在社区老年人中,随着ASMI的增加,3组TG/HDL-C也增加,差异有统计学意义(P=0.004)。Spearman相关分析显示,ASMI与男性、SBP、DBP、基础代谢量、肌肉量、腰臀比、TG/HDL-C和ALT均呈正相关(P<0.05)。多因素Logistic回归分析显示:性别(OR=0.130,95%CI:0.027~0.635)、TG/HDL-C(OR=0.575,95%CI:0.332~0.996)、肌肉量(OR=0.609,95%CI:0.485~0.766)、基础代谢量(OR=1.011,95%CI:1.001~1.021)是ASMI的独立影响因素。结论TG/HDL-C有助于预测老年人ASMI的下降趋势,对筛查社区老年人可疑肌少症病人具有一定临床意义。

减重对2型糖尿病合并超重肥胖患者肌肉含量的临床观察

目的探讨减重对2型糖尿病(type 2 diabetes mellitus,T2DM)合并超重肥胖患者肌肉含量的影响。方法选取2020年4月至2021年9月北京市海淀医院T2DM合并超重肥胖患者48例,给予糖尿病健康宣教,并采用饮食控制的方式减重12周,减重期可根据血糖水平调整降糖药物用量,但避免使用胰高糖素样肽-1(glucagon-like peptide-1,GLP-1)受体激动剂。比较减重前后患者的肌肉含量,采用Pearson相关分析法分析四肢骨骼肌质量指数(appendicular skeletal muscle mass index,ASMI)下降值与体成分各指标下降值的相关性。结果48例患者中男33例、女15例,年龄24~59岁,平均(43.5±9.8)岁。与基线相比,减重后的ASMI[(6.91±1.02)kg/m^(2)比(7.21±0.97)kg/m^(2)]、体质量[(81.85±13.13)kg比(88.45±13.70)kg]、腰围(waist circumference,WC)[(95.34±8.07)cm比(101.65±8.86)cm]、体脂百分比[36.9(32.7,42.2)%比38.7(36.2,43.2)%]、内脏脂肪面积(visceral fat area,VF)[(179.77±48.32)cm^(2)比(209.92±42.78)cm^(2)]均较低,但四肢骨骼肌百分比较高[(0.25±0.03)%比(0.24±0.03)%],差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,ASMI下降值与体质量(r=0.440,P=0.002)、BMI(r=0.426,P=0.003)、WC(r=0.340,P=0.018)、总肌肉质量(r=0.665,P<0.001)的下降值呈正相关。结论T2DM合并超重肥胖患者减重后代谢指标明显改善,但会造成肌肉含量下降,建议减重同时注意权衡减重的获益,在监测体成分变化的同时,酌情保留或加大运动量,并关注肌肉含量,减少肌少症的发生。