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超越肉症:慢性血液透析患者的脆弱性
Jean-Sébastien Souweine1, Grégoire Pasquier2, Marion Morena1
1PhyMedExp, University of Montpellier, INSERM, CNRS, Department of Biochemistry and Hormonology, University Hospital Center of Montpellier, Montpellier, France.
Clinical kidney journal
|July 10, 2024
概括
慢性血液透析 (HD) 患者的脆弱性评估至关重要. 短物理性能电池 (SPPB),特别是平衡测试,有效地预测存活率并识别高风险患者.
科学领域:
- 老年学是指老年学的学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 物理疗法物理治疗
背景情况:
- 脆弱性是慢性血液透析 (HD) 患者的一个重大问题,增加了对不良事件的脆弱性和易感性.
- 肉,肌肉质量和力量的损失,可能会通过减少功能能力和自治来加剧脆弱.
- 对于HD患者来说,最佳的床边脆弱性评估工具仍在讨论中.
研究的目的:
- 调查虚弱对慢性HD患者存活率的影响.
- 为了确定与此群体的脆弱性相关的因素.
- 评估定时启动和启动 (TUG) 和短物理性能电池 (SPPB) 测试对脆弱性评估的实用性.
主要方法:
- 一项前性研究追踪了114名患有HD的慢性疾病患者,持续了大约23.7个月.
- 在基线时,使用TUG和SPPB测试来评估脆弱性,这些测试包括步行速度,平衡和下肢力量的测量.
- 收集和分析患者生存数据与脆弱性评估得分相关.
主要成果:
- 30名患者 (26.3%) 在随访期间死亡. 已故的患者年龄较大,患病并发症较多,肉症患病率较高.
- 在死亡的患者中观察到明显较低的SPPB和TUG得分.
- 较高的SPPB总得分 (> 9) 与死亡风险降低独立相关 (HR 0.83; P < .03). 在多变量分析中,SPPB平衡测试组件显示了保护作用.
结论:
- 使用SPPB查脆弱性,特别是平衡组件,对于慢性HD患者至关重要.
- 肌肉力量降低和蛋白质摄入不足会对SPPB得分和平衡产生负面影响.
- 有效的脆弱性识别和管理可以改善HD患者的临床结果.
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