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目的通过检测最大握力、骨骼肌质量指数和6 m步行速度等肌肉减少症相关参数,探讨冠心病患者骨骼肌力量情况及相关影响因素。方法选取2015年9月至2016年1月于本院心内科心脏康复中心就诊的患者310例为研究对象,根据临床诊断,将患者分为心肌梗死组(107例),心绞痛组(145例)及对照组(非冠心病患者,58例)。收集入选患者的一般资料、生化指标、超声心动图参数、心肺运动试验参数、体质成分检测结果、握力、骨骼肌质量指数及6 m步行速度检测结果,应用多元线性回归方法分析其独立影响因素。结果患者平均年龄为(58.5±8.5)岁,男性占81.0%,平均握力、骨骼肌质量指数和6 m步行速度分别为(31.1±7.8)kg、(10.3±1.3)kg/m2和(1.3±0.2)m/s。分别以握力、骨骼肌质量指数和6 m步行速度作为因变量,将患者各项临床指标作为自变量进行多元线性回归分析,结果显示二尖瓣环收缩期峰值速度(systolic velocity of mitral annulus,Sm)与上述指标均呈正相关(P分别为0.001、0.031及0.022),规律运动是握力和6 m步行速度的独立影响因素(P分别为0.033和0.025)。结论左室收缩功能可影响冠心病患者骨骼肌力量相关指标,规律运动者握力和6 m步行速度较好。
Objective To investigate the relationship between skeletal muscle strength and related factors in patients with coronary heart disease (CHD) by testing parameters such as maximal grip strength, skeletal muscle mass index and 6 m walking speed. Methods A total of 310 patients were enrolled in this study from September 2015 to January 2016. The patients were divided into myocardial infarction group (107 cases), angina pectoris group (145 cases) And control group (non-CHD patients, 58 cases). General information, biochemical indexes, echocardiographic parameters, cardiopulmonary exercise parameters, body composition test results, grip strength, skeletal muscle mass index and 6 m walking speed test results were collected. The multivariate linear regression analysis was used to analyze the independent influencing factors. Results The average age of patients was (58.5 ± 8.5) years old and male was 81.0%. The mean grip strength, skeletal muscle mass index and walking speed of 6 m were (31.1 ± 7.8) kg, (10.3 ± 1.3) kg / m2 and 0.2) m / s. Multivariate linear regression analysis of each patient’s clinical variables with Grip Strength, Skeletal Muscle Mass Index and 6-m walking speed as independent variables showed that the systolic velocity of mitral annulus (Sm ) Were positively correlated with the above indexes (P = 0.001, 0.031 and 0.022, respectively). Regular exercise was an independent factor of grip strength and 6 m walking speed (P = 0.033 and 0.025, respectively). Conclusion Left ventricular systolic function can affect skeletal muscle strength-related parameters in patients with coronary heart disease, regular exercise grip strength and walking speed 6 m better.