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在患有类风湿性肌肉骨疾病的患者中 Sarcopenia
Hironari Hanaoka1, Jun Kikuchi1, Kazuoto Hiramoto1
1Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
International journal of rheumatic diseases
|August 4, 2023
概括
高剂量葡萄糖皮质激素治疗在住院的类风湿病患者中恶化了肉症. 早期体重下降预示着肌肉损失,这表明需要在治疗期间进行监测.
科学领域:
- 类风湿病学 类风湿病学
- 老年病的医生 老年病的医生
- 内分泌学 在内分泌学.
背景情况:
- 标志着肌肉质量和力量损失的萨尔科佩尼亚是患有风湿性肌肉骨疾病 (RMDs) 的患者的担忧.
- 高剂量葡萄糖皮质激素治疗经常用于RMD,但可能对肌肉健康产生不良影响.
研究的目的:
- 评估高剂量葡萄糖皮质体治疗对住院RMD患者肉症进展的影响.
- 为了确定肉症进展的预测因素和相关的临床结果.
主要方法:
- 对接受高剂量葡萄糖皮质体治疗的住院RMD患者 (2020-2022) 的回顾性分析.
- 骨质量指数 (SMI) 测量在治疗前和治疗后一个月,以确定肉症的进展 (>10% SMI 减少).
- 患者之间临床特征和结局的比较,有和没有萨尔科佩尼亚进展.
主要成果:
- 83.7%的患者在基线时患有肉类;57.1%的患者在治疗1个月后出现进展.
- 萨科佩尼亚的进展与男性性别,更高的体重和更高的基线SMI有关.
- 在第一周内早期体重减轻 (切断值-1.8公斤) 预测了肉类的进展 (OR:0.22,P=0.007).
- 渐进性的肉类与更高的感染发病率有关.
结论:
- 住院治疗高剂量葡萄糖皮质激素治疗显著促进RMD患者的肉症进展.
- 监测早期的体重变化可以帮助预测并可能减轻肌肉体积损失.
- 这些发现凸显了在治疗RMD时管理肌肉健康的重要性.
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