Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients
Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients
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DOI：
10.1159/000500415
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发表时间：
2019-01-01
影响因子：
2.4
通讯作者：
Akima, Hiroshi
中科院分区：
文献类型：
--
作者：
Maeda, Hisashi;Imada, Ken;Akima, Hiroshi
简介：四头肌萎缩和质量损失，定义为肌内脂肪和/或结缔组织的比例增加，经常观察到，特别是在中风后患者的瘫痪肢体中。本研究旨在探讨脑卒中后股四头肌厚度（MT）与肌肉回声强度（EI）及运动性瘫痪严重程度的关系。方法：36例脑卒中后亚急性期偏瘫患者入组。我们检查了MT（肌肉数量指数）和EI（肌肉质量指数）在大腿前中部在两个肢体。我们还评估了Brunnstrom分期（BR分期）、皮下脂肪组织厚度、卒中后时间、年龄、体重、性别、药物治疗次数以及营养和炎症状态。结果如下：轻瘫肢体中的MT由BR分期（=-0.26，p < 0.01）、体重（= 0.68，p < 0.01）和血清白蛋白（= 0.34，p < 0.01）解释，调整后的R-2为0.81。非轻瘫肢体的MT由肌肉EI（=-0.55，p < 0.01）和年龄（=-0.40，p < 0.01）解释，校正后的R-2为0.69。轻瘫肢体（=-0.34，p < 0.01）和非轻瘫肢体（=-0.69，p < 0.01）的MT解释了肌肉EI。结论：我们的研究结果表明，运动麻痹，衰老和营养不良有助于中风后患者的股四头肌萎缩。此外，减少肌肉质量损失的潜在对策是维持肌肉数量。
Introduction: Quadriceps muscle atrophy and quality loss, defined as an increased ratio of intramuscular fat and/or connective tissue, are often observed especially in the paretic limb of post-stroke patients. This study was performed to examine the relationship of quadriceps muscle thickness (MT) with muscle echo intensity (EI) and the severity of motor paralysis after stroke. Methods: Thirty-six hemiparetic subacute post-stroke patients were enrolled. We examined the MT (index of muscle quantity) and the EI (index of muscle quality) at the anterior mid-thigh in both limbs. We also assessed the Brunnstrom stage (BR stage), subcutaneous adipose tissue thickness, time since stroke, age, body weight, sex, number of medications, and nutritional and inflammation status. Results: The MT in the paretic limb was explained by the BR stage ( = -0.26, p < 0.01), body weight ( = 0.68, p < 0.01), and serum albumin ( = 0.34, p < 0.01), with an adjusted R-2 of 0.81. The MT in the non-paretic limb was explained by the muscle EI ( = -0.55, p < 0.01) and age ( = -0.40, p < 0.01), with an adjusted R-2 of 0.69. The muscle EI was explained by the MT in the paretic limb ( = -0.34, p < 0.01) and non-paretic limb ( = -0.69, p < 0.01). Conclusions: Our results suggest that motor paralysis, aging, and malnutrition contribute to quadriceps atrophy in post-stroke patients. Moreover, a potential countermeasure to diminish muscle quality loss is maintenance of muscle quantity.