Muscle strength, Na,K-pumps, magnesium and potassium in patients with alcoholic liver cirrhosis - relation to spironolactone
Muscle strength, Na,K-pumps, magnesium and potassium in patients with alcoholic liver cirrhosis - relation to spironolactone
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DOI：
10.1046/j.1365-2796.2002.01008.x
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发表时间：
2002-07-01
影响因子：
11.1
通讯作者：
Dorup, I
中科院分区：
文献类型：
--
作者：
Aagaard, NK;Andersen, H;Dorup, I
目标。目的：评价酒精性肝硬变患者肌力与肌镁(Mg)、钾(K)和钠钾(Na，K)泵含量的关系。一项开放式横断面研究。设置和受试者。连续51名在丹麦奥胡斯大学医院肝科住院的肝硬变患者和28名年龄和性别匹配的健康对照受试者。对患者和对照组进行骨骼肌活组织检查，以测量镁、钾、钠、钾泵。此外，还评估了膝关节最大等速伸展和骨骼肌质量。患者的肌肉质量、肌力、肌肉镁和肌钾显著降低(P<；0.01)，并随着肝病严重程度的增加而下降，反映在Child-Pugh(C-P)分级中。服用螺内酯2周或以上的患者肌力、肌镁和Na，K泵含量均高于其余患者(均P<；0.05)。在对患者进行的多因素分析中，骨骼肌重、肌镁和每日饮酒量(G)是等速肌力的独立预测因素(P<；0.05)。酒精性肝硬变患者的肌力显著降低，肌肉镁是肌力的独立预测因子。令人惊讶的是，在接受螺内酯治疗的患者中，肌肉无力不那么明显，可能是因为螺内酯对肌肉镁、钾和钠、钾泵含量的影响。
Objectives. To evaluate the muscle strength in relation to muscle contents of magnesium (Mg), potassium (K) and sodium, potassium (Na,K)-pumps in patients with alcoholic cirrhosis.Design. An open cross-sectional study.Setting and subjects. Fifty-one consecutive patients with liver cirrhosis admitted to the Department of Hepatology, Aarhus University Hospital, Denmark, and 28 age- and sex-matched healthy control subjects.Main outcome measures. Biopsies of skeletal muscle were performed in patients and controls for measurements of Mg, K, and Na,K-pumps. Furthermore, maximum isokinetic knee extension and skeletal muscle mass were evaluated.Results. Muscle mass, muscle strength, muscle Mg and muscle K were substantially reduced in the patients (P < 0.01, all), and fell with increasing severity of the liver disease reflected in the Child-Pugh (C-P) class. Patients treated with spironolactone for 2 weeks or more, had increased muscle strength, muscle Mg and content of Na,K-pumps, compared with the rest of the patients (P < 0.05, all). In a multivariate analysis of the patients, skeletal muscle mass, muscle Mg and daily alcohol consumption (g) were independent predictors of isokinetic muscle strength (P < 0.05, all).Conclusions. Patients with alcoholic liver cirrhosis showed considerably reduced muscle strength and muscle Mg was an independent predictor of muscle strength. Surprisingly, in the spironolactone treated patients, muscle weakness was less pronounced, possibly because of the action of spironolactone on muscle Mg, K and Na,K-pump content.