| 王冠荀,薛倩,邓利华,等.老年衰弱患者吞咽肌肉影像学特征分析[J].中国临床保健杂志,2025,28(4):439-444. |
| 老年衰弱患者吞咽肌肉影像学特征分析 |
| Clinical characteristics of frail elderly patients and analysis of imaging features of swallowing muscles |
| 投稿时间：2025-04-02 |
| DOI：10.3969/J.issn.1672-6790.2025.04.002 |
| 中文关键词: 衰弱 体征和症状 吞咽障碍 肌减少症 体层摄影术,X线计算机 老年人 |
| 英文关键词: Frailty Signs and symptoms Deglutition disorders Sarcopenia Tomography,X-ray computed Aged |
| 基金项目:北京市自然科学基金资助项目(7242152) |
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| 摘要点击次数: 8 |
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| 中文摘要: |
| 目的 分析老年衰弱患者的临床特征及吞咽相关肌肉影像学改变的临床意义。方法 本研究为回顾性队列研究,共纳入2018年3月至2024年10月北京大学人民医院进行标准吞咽功能评价量表(SSA量表)评估的214例住院患者资料。通过衰弱评估量表(FRAIL量表)筛查衰弱,应用CT定量分析咬肌、食管上括约肌等吞咽相关肌肉的面积与密度。结果 随着衰弱程度加重,年龄、Morse跌倒评分、吞咽障碍比例、肌少症比例呈上升趋势,日常生活活动能力评分、白蛋白、三酰甘油、血红蛋白、游离三碘甲状腺原氨酸、三碘甲状腺原氨酸水平呈下降趋势。吞咽障碍的比例从非衰弱的1.19%到衰弱前期的15.62%,再到衰弱的70.59%。衰弱患者咬肌面积[衰弱组(9.64±3.24)cm2,非衰弱组(12.58±3.76)cm2,P=0.015]和食管上括约肌密度[衰弱组(39.1±9.22)HU,非衰弱组(54.79±12.66)HU,P<0.001]比非衰弱组低。结论 衰弱患者具有低白蛋白血症、低血红蛋白、低游离三碘甲状腺原氨酸、低三碘甲状腺原氨酸的临床特点。CT定量评估吞咽肌肉形态学特征可为衰弱早期筛查及干预提供客观影像学依据。 |
| 英文摘要: |
| Objective To analyze the clinical characteristics and imaging changes of swallowing related muscles in elderly patients with frailty,and explore their clinical significance.Methods This study was a retrospective cohort study that included data from 214 hospitalized patients who were evaluated using the Standard Swallowing Function Assessment (SSA) Scale at Peking University People′s Hospital from March 2018 to October 2024.Screening for frailty using the Frail Assessment Scale (FRAIL) and applying CT quantitative analysis of the area and density of swallowing related muscles such as the masseter muscle and upper esophageal sphincter.Results As the degree of weakness increased,age,Morse fall score,proportion of swallowing disorders,and proportion of sarcopenia showed a gradually increasing trend,while activities of daily living (ADL) score,albumin (ALB),triglycerides (TG),hemoglobin (Hb),free triiodothyronine (FT3),and triiodothyronine (T3) showed a decreasing trend.Low ALB and low Hb reflect the characteristics of low nutritional status in frail patients.The proportion of swallowing disorders changed significantly,from 1.19% in non frailty to 15.62% in pre frailty,and then to as high as 70.59% in frailty.CT showed that the masseter muscle area in the weakened group (9.64±3.24) cm2,non weakened group (12.58±3.76) cm2,P=0.015,and the density of the upper esophageal sphincter muscle in the weakened group (39.1±9.22) HU,non weakened group (54.79±12.66) HU(P<0.001) were lower than those in the non weakened group.Conclusions Patients with frailty have clinical characteristics of low ALB,low Hb,low FT3,and low T3.CT quantitative evaluation of swallowing muscle morphological characteristics can provide objective imaging evidence for early screening and intervention of frailty. |
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