脑卒中伴肌少症的临床特征及早期微生态肠内营养干预效果分析

doi:10.3969/j.issn.1003-9198.2023.08.00

摘要/Abstract

摘要： 目的探讨脑卒中伴肌少症病人的临床特征及早期微生态肠内营养干预的效果。方法回顾性选取中国石油中心医院神经内科自2020年5月至2021年12月收治的60例脑卒中伴肌少症病人作为脑卒中伴肌少症组,选取同期收治的60例脑卒中不伴肌少症病人作为对照组,比较2组的临床特征。将伴有肌少症的脑卒中病人按照是否给予早期微生态肠内营养干预分为常规组(n=30)和早期微生态营养组(n=30),比较2组病人干预前和干预3个月后BMI、MMSE评分、Rankin修订量表(mRS)评分、ADL评分、美国国立卫生研究院卒中量表(NIHSS)评分、四肢骨骼肌(SMI)指数及肌肉握力、肌肉质量、5次起坐试验(FTSST)、改良Romberg试验的差异。结果脑卒中伴肌少症组的年龄、NIHSS评分高于对照组,BMI、MMSE评分、ADL评分、mRS评分低于对照组, 差异有统计学意义(P<0.05)。脑卒中伴肌少症组经早期微生态肠内营养干预3个月后的BMI、MMSE评分、ADL评分、SMI指数、肌肉握力、总肌肉量、前后半脚闭眼时间、前后脚睁眼时间均高于治疗前和干预后的常规组,FTSST时间、NIHSS评分、mRS评分均低于治疗前和干预后的常规组(P<0.05)。结论合并肌少症的脑卒中病人日常生活能力降低,神经功能缺损严重,但早期微生态肠内营养干预可改善其肌肉力量,促进躯体能力的恢复,提高日常生活能力,减轻神经功能缺损。

关键词: 肌少症, 脑卒中, 微生态肠内营养, 肌肉力量, 预后

Abstract: Objective To investigate the clinical characteristics of stroke combined with sarcopenia, and to investigate the effect of early intervention of microecological enteral nutrition. Methods A total of 60 patients with stroke combined with sarcopenia who were admitted to Department of Neurology, PetroChina Central Hospital from May 2020 to December 2021 were enrolled in the stroke with sarcopenia group, and 60 patients with stroke who did not present with sarcopenia were enrolled in the control group. The clinical characteristics of the two groups were compared. The patients with stroke combined with sarcopenia were divided into the early microecological group and the conventional group according to whether they received early microecological enteral nutrition intervention or not, with 30 patients in each group. After 3 months intervention, body mass index(BMI), prognosis-related scores such as Mini-Mental StateExamination(MMSE) score and modified Rankin scale(mRS) score, muscle grip strength, muscle mass, 5-times sit-to-stand test(FTSST) and modified Romberg test were detected and compared. Results The age and National Institutes of Health Stroke Scale(NIHSS) score in the stroke with sarcopenia group were higher than those in the control group, and the levels of BMI, MMSE score, activities of daily living(ADL) score, mRS score were lower than those in the control group(P<0.05). BMI, MMSE score, ADL score, skeletal muscle index (SMI) of limbs, muscle grip strength, total muscle mass, eye closing time of front and back half of foot and eye opening time of front and back of feet in the early microecological group after treatment were higher than those before treatment and those in the conventional group, while FTSST time, NIHSS score and mRS score were lower than those before treatment and those in the conventional group. Conclusions Sarcopenia can reduce the ability of daily living of the patients with stroke and cause serious neurological deficits, but early microecological enteral nutrition intervention can improve muscle strength, promote the recovery of physical ability, and improve daily life.

Key words: sarcopenia, stroke, microecological enteral nutrition, muscle strength, prognosis

中图分类号:

杨文杰, 李艳丽, 周彦君, 李兰, 穆斌, 王杰. 脑卒中伴肌少症的临床特征及早期微生态肠内营养干预效果分析[J]. 实用老年医学, 2023, 37(8): 823-827.

YANG Wen-jie, LI Yan-li, ZHOU Yan-jun, LI Lan, MU Bin, WANG Jie. Clinical characteristics of stroke combined with sarcopenia and the effect of early microecological enteral nutrition intervention[J]. Practical Geriatrics, 2023, 37(8): 823-827.

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