肌少症相关吞咽障碍的研究进展

doi:10.3969/j.issn.1006-9771.2020.03.016

摘要/Abstract

摘要：

肌少症是与增龄相关的广泛性、进行性肌肉质量和力量丧失以及功能减低的综合征,严重影响老年人生活质量和社会参与。肌少症可能导致吞咽功能变化,而吞咽障碍也可增加肌少症患病率;另一方面,肌少症累及吞咽相关肌肉,也可增加营养不良及误吸风险。因此提出“肌少症性吞咽障碍”的概念。肌少症的筛查评估主要采用CT、MRI、超声等辅助检查和共识指南,干预措施主要有功能训练、营养管理和药物治疗等。早期识别、早期干预对改善患者生活质量和预后至关重要。

关键词: 肌少症, 吞咽障碍, 综述

Abstract:

Sarcopenia is an age-related syndrome of extensive, aggressive muscle mass loss and function reducing, which seriously affects the quality of life and social participation of the elderly. Dysphagia can increase the prevalence of sarcopenia, in another hand, sarcopenia can also implicate swallow related muscles, to increase the risk of malnutrition and aspiration. In recent years, the concept of sarcopenic dysphagia has been widely recognized in many researches. Sarcopenia is mainly screened with CT, MRI, ultrasound, and other auxiliary examination, as well as consensus guidelines. Interventions for it mainly include functional training, nutrition management and drug therapy. Early identification and intervention are important for the outcome and quality of life of patients.

Key words: sarcopenia, dysphagia, review

中图分类号:

R685

李博宁,陈健尔. 肌少症相关吞咽障碍的研究进展[J]. 《中国康复理论与实践》, 2020, 26(3): 344-349.

LI Bo-ning,CHEN Jian-er. Advance in Sarcopenia-related Dysphagia (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(3): 344-349.

图/表 1

参考文献 70

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项目	EWGSOP	IWGS	AWGS	中国	EWGSOP2
步速	< 0.8 m/s (4米步行测试)	< 1 m/s (4米步行测试)	< 0.8 m/s (6米步行测试)	≤ 0.8 m/s,测评肌量;> 0.8 m/s,测评握力	< 0.8 m/s(严重肌少症)
握力	< 30 kg(男) < 20 kg(女)	未提及	< 26 kg(男) < 18 kg(女)	< 25 kg(男) < 18 kg(女)	< 27 kg(男) < 16 kg(女)
肌肉质量指数	DXA：男性≤ 7.26 kg/m²,女性≤ 5.5 kg/m² BIA：男性≤ 8.87 kg/m²,女性≤ 6.42 kg/m²	男性≤ 7.23 kg/m², 女性≤ 5.67 kg/m²	DXA：男性≤ 7.0 kg/m²,女性≤ 5.4 kg/m² BIA：男性≤ 7.0 kg/m², 女性≤ 5.7 kg/m²	首选DXA：低于参照青年健康人峰值的-2个标准差	男性≤ 7.0 kg/m²,女性≤ 5.5 kg/m²
简易体能状况量表	≤ 8分	未提及	< 9分	未提及	≤ 8分
400米步行测试	未提及	未提及	未提及	未提及	未完成或> 6 min完成
计时起立行走测试	无具体切点	未提及	未提及	未提及	≥ 20 s
椅子支架测试	未提及	未提及	未提及	未提及	> 15 s