| 许兵,周琪,冯金苹,李晓琳,戴寿旺,薛洋洋,王萧枫.骨质疏松患者的骨骼与肌肉的临床相关性研究[J].浙江中西医结合杂志,2020,30(8): |
| 骨质疏松患者的骨骼与肌肉的临床相关性研究 |
| Study On The Clinical Correlation Between Bone and Muscle in Osteoporosis PatientsXu Bing, Zhou Qi, Feng Jin-ping, Li Xiao-lin, Dai Shou-wang, |
| 投稿时间：2020-03-22 修订日期：2020-06-01 |
| DOI： |
| 中文关键词: 骨质疏松症 骨骼 肌肉 跌倒 相关性 |
| 英文关键词:Osteoporosis Bone Muscle Hendrich Fall Score The Correlation Analysis |
| 基金项目:温州市公益性科技计划项目(Y20170410)，温州市中医药科研项目(2017ZA04)，温州市基础性科研项目（Y20180798） |
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| 中文摘要: |
| 目的 通过研究骨质疏松患者的骨骼与肌肉的相关性,探讨骨肌系统的整体统一性,指导临床对于骨肌系统的重视。方法：2017年12月至2018年12月在我院住院或门诊随访的符合纳入与排除标准的骨质疏松患者60例,其中男24例,年龄65-89岁,平均(74.42±5.87)岁,女36例,年龄60-85岁,平均(71.89±6.14)岁,记录一般资料后均采用DXA进行全身扫描,记录骨骼的骨密度T值(BMD)、骨矿含量(BMC)和肌肉的相对骨骼肌质量指数(RSMI),进行握力、简易步数及Hendrich II跌倒量表评估测定,采用BMD评估骨质疏松程度及RSMI判断肌肉肌量情况,分析所有患者的骨骼、肌肉与性别的相关性,比较骨骼、肌肉的相关指标与年龄、Hendrich II跌倒量表评分的相关性,并对骨骼的BMD、BMC与肌肉的RSMI、握力、简易步数评分进行相关性分析。结果：所有骨质疏松症患者根据RSMI判断肌量发现肌肉减少占50%,其中男性的肌肉减少发生率占所有男性患者的66.67%,高于女性,差异有统计学意义(P<0.05),并且男性骨骼的BMC和肌肉的RSMI、握力及简易步数评分均高于女性,差异均具有统计学意义(P<0.05),但男性与女性的骨质疏松程度BMD及跌倒风险无差异(P>0.05)。所有患者骨骼的BMD、BMC和肌肉的RSMI、握力、简易步数评分均与年龄呈负相关(r=-0.799、-0.405、-0.323、-0.248、-0.389,P<0.01),并且还与Hendrich II跌倒评分亦均呈负相关(r=-0.633、-0.744、-0.481、-0.403、-0.408,P<0.01),而年龄与Hendrich II跌倒评分呈正相关(r=0.672,P<0.01)；所有患者肌肉的RSMI、握力、简易步数评分与骨骼的BMD均呈正相关,具有统计学意义(r=0.434、0.403、0.355,P<0.01),还与骨骼的BMC亦均呈正相关,具有统计学意义(r=0.652、0.579、0.494,P<0.01)。结论：骨质疏松患者多伴有肌肉减少,男性发生率高,女性的骨肌系统弱于男性,但骨质疏松程度与跌倒风险无性别差异,并且骨骼与肌肉具有正相关性,年龄越大,骨质疏松越严重,肌肉肌量越少、肌力越小、功能越差,越容易跌倒,临床应该注意将骨肌系统进行协同性诊治。 |
| 英文摘要: |
| Objective: To explore the integrity of the skeletal muscle system and Guide clinical attention to skeletal muscle system by studying the relationship between bone and muscle in patients with osteoporosis. Methods: The 60 osteoporosis patients who met the inclusion and exclusion criteria were followed up in our hospital from December 2017 to December 2018. The male were 24, 65-89 years old, with an average age of (74.42 ± 5.87) years, and the female were 36, 60-85 years old, with an average age of (71.89 ± 6.14) years among them. General information of all patients was recorded, bone mineral density (BMD) and Bone mineral content (BMC) of bone were measured and recorded after Whole body scanning with DXA, the relative skeletal muscle mass index (RSMI), grip strength and simple steps score were measured to evaluate muscle condition, and the fall risk was assessed by Hendrich II fall scale. The relationship between skeletal and muscle and gender was studied in all osteoporosis patients, the correlation between skeletal and muscle indexes and age, Hendrich II Fall Scale scores were compared, the correlation between BMD, BMC of bone and RSMI, grip strength and simple steps scores of muscle was analyzed. Result: 50% of all osteoporosis patients had muscle loss according to RSMI. The incidence of muscle loss in male was 66.67%, higher than that in female (P < 0.05), and the BMC of bone, RSMI, grip strength and simple steps score of muscle in male were higher than those in female (P < 0.05), but there was no difference in BMD and risk of falls between men and women (P > 0.05). The BMD, BMC of bone and RSMI, grip strength and simple steps score of muscle of all osteoporosis patients were negatively correlated with age (r = -0.799, - 0.405, - 0.323, - 0.248, - 0.389, P < 0.01), and they were also negatively correlated with Hendrich II fall score(r=-0.633、-0.744、-0.481、-0.403、-0.408,P<0.01),but There was a positive correlation between age and Hendrich fall score (r = 0.672, P < 0.01). The RSMI, grip strength and simple steps score of all osteoporosis patients were positively correlated with BMD of bone (r = 0.434, 0.403, 0.355, P < 0.01), and they were also positively correlated with BMC of bone(r=0.652、0.579、0.494,P<0.01). Conclusion: The osteoporosis patients are often accompanied by muscle loss, the incidence of male is high. The musculoskeletal system of women is weaker than that of men, but there was no gender difference between degreeSofSosteoporosis and risk of falls. Bone and muscle are closely related, the patient is older, osteoporosis is more serious, muscle mass is less, muscle strength is less, function of muscle is even worse, and it is more prone to falls. Cooperative diagnosis and treatment of bone and muscle of skeletal muscle system should be paid more attention in clinical practice. |
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