Prevalence and Morbidity Associated with Muscle Cramps in Patients with Cirrhosis
Prevalence and Morbidity Associated with Muscle Cramps in Patients with Cirrhosis
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DOI：
10.1016/j.amjmed.2012.03.012
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发表时间：
2012-10-01
影响因子：
5.9
通讯作者：
Vuppalanchi, Raj
中科院分区：
文献类型：
--
作者：
Chatrath, Hemant;Liangpunsakul, Suthat;Vuppalanchi, Raj
目的：肝硬化患者经常经历肌肉痉挛的严重程度不同。我们调查了与肌肉痉挛相关的患病率和发病率相关的因素。疼痛，慢性肝病问卷（CLDQ）和血液测量25-（OH）维生素D水平的疼痛，慢性肝病问卷调查表的抽筋问卷调查表：总共获得了101例患者（67％）报告的肌肉痉挛。在前3个月中。抽筋患者的血清白蛋白（3.1 +/- 0.6 g/dl vs 3.3 +/- 0.7 g/dl，p = .04）和CLDQ分数（107 +/- 37 +/- 37 +/- 34，p < .0001）与没有抽筋的那些相比。在研究队列中，定义为抽筋频率和严重程度的乘积的中值复合症状评分为12，范围为0.3至200。 12）。肌肉痉挛（P <.001）和肝性脑病（P = .009）与CLDQ分数降低独立相关。在66％的研究队列中出现了维生素D缺乏症，但在有和没有抽筋的患者之间，血清25-（OH）维生素D水平没有显着差异（18.0 +/- 8.9 ng/ml vs 19.6 +/- 9.5 ng /ml，p = .49）。结论：肌肉痉挛与肝硬化患者的生活质量显着降低有关。需要进行更多的研究，以更好地了解他们开发有效治疗的机制。 （c）2012 Elsevier Inc.保留所有权利。 《美国医学杂志》（2012）125，1019-1025
PURPOSE: Patients with cirrhosis often experience muscle cramps with varying severity. We investigated the factors associated with the prevalence and morbidity associated with muscle cramps.METHODS: A total of 150 adult patients with cirrhosis were enrolled consecutively. Cramp questionnaire with visual analogue scale for pain, Chronic Liver Disease Questionnaire (CLDQ), and blood for measurement of 25-(OH) vitamin D levels were obtained after informed consent.RESULTS: A total of 101 patients (67%) reported muscle cramps in the preceding 3 months. Patients with cramps had significantly lower serum albumin (3.1 +/- 0.6 g/dL vs 3.3 +/- 0.7 g/dL, P = .04) and CLDQ scores (107 +/- 37 vs 137 +/- 34, P < .0001) compared with those without cramps. The median composite symptom score, defined as product of frequency and severity of cramps, in the study cohort was 12 with a range of 0.3 to 200. There were no clinical or biochemical predictors for occurrence of any cramps or severe cramps (composite symptom score > 12). Muscle cramps (P < .001) and hepatic encephalopathy (P = .009) were associated independently with decreased CLDQ scores. Vitamin D deficiency was seen in 66% of the study cohort, but the serum 25-(OH) vitamin D levels were not significantly different between patients with and without cramps (18.0 +/- 8.9 ng/mL vs 19.6 +/- 9.5 ng/mL, P = .49).CONCLUSIONS: Muscle cramps are associated with significantly diminished quality of life in patients with cirrhosis. More research is needed to better understand their mechanism to develop effective treatment. (C) 2012 Elsevier Inc. All rights reserved. The American Journal of Medicine (2012) 125, 1019-1025