心血管手术后手术前的内脏脂肪和肌肉损失:一个回顾性队列研究
Kazuya Shimizu1,2, Ryota Matsuzawa3, Shinya Nakamura1
1Department of Rehabilitation, Sumitomo Hospital, Osaka, Japan.
JPEN. Journal of parenteral and enteral nutrition
|December 18, 2025
概括
手术前的内脏脂肪质量预测心血管手术后显著的骨肌肉损失. 内脏肥胖会放大炎症,加速肌肉退化,增加患者的风险.
科学领域:
- 心血管外科心血管外科
- 身体组成分析 身体成分分析
- 炎症反应 炎症反应
背景情况:
- 内脏肥胖会增加外科手术期间的全身炎症,增加感染风险.
- 心血管手术后的骨肌损失是一个重大的临床问题.
- 计算机断层扫描 (CT) 有助于评估身体组成及其临床影响.
研究的目的:
- 为了研究术前内脏脂肪质量和术后骨肌肉损失之间的关联.
- 评估基于CT的身体组成分析在预测肌肉损失方面的临床实用性.
- 了解内脏肥胖在外科手术期间炎症和肌肉代谢中的作用.
主要方法:
- 对接受选择性心血管手术的日本患者进行回顾性队列研究 (2020年5月 - 2023年12月).
- 术前CT用于测量内脏脂肪区域,皮下脂肪区域和psoas肌肉区域 (骨肌肉指标).
- 骨肌的损失量化通过从手术前到手术后的 psoas 肌肉区域的变化.
主要成果:
- 术前较高的内脏脂肪区域与增加的C-反应蛋白 (CRP) 和较大的psoas肌肉区域损失有显著的相关性.
- 皮下脂肪区域与这些结果没有显著的相关性.
- 多变量分析证实内脏脂肪区域是术后骨肌损失的重要预测因素 (OR:1.01;95% CI:1.00-1.02).
结论:
- 通过CT评估的手术前内脏脂肪质量是术后骨肌肉损失的可靠预测指标.
- 内脏肥胖可能会通过增加全身炎症和炎症前路径加剧肌肉损失.
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