Ultrasonography to Measure Swallowing Muscle Mass and Quality in Older Patients With Sarcopenic Dysphagia
Ultrasonography to Measure Swallowing Muscle Mass and Quality in Older Patients With Sarcopenic Dysphagia
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DOI：
10.1016/j.jamda.2017.11.007
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发表时间：
2018-06-01
影响因子：
7.6
通讯作者：
Ogawa, Sumito
中科院分区：
文献类型：
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作者：
Ogawa, Nami;Mori, Takashi;Ogawa, Sumito
工作背景：肌源性吞咽困难的特征在于由于全身骨骼和吞咽肌肉质量和功能的丧失而导致的吞咽困难。然而，没有研究报告吞咽肌肉质量和质量的患者sarcopenic dysphagia.Objective：比较吞咽肌肉质量和质量的差异sarcopenic和nonsarcopenic dysphagia.Method：一个横断面研究进行了55例老年患者，谁被建议进行吞咽困难的评估和/或康复。使用肌肉减少性吞咽困难的诊断算法诊断肌肉减少性吞咽困难。舌肌和颏舌骨肌（冠状面和矢状面）的厚度和面积，以及舌和颏舌骨肌的回声强度进行了检查，通过ultrason.Results：研究参与者包括31名男性和24名女性（平均年龄82 +/- 7岁），与14个可能的肌肉减少性吞咽困难，22个可能的肌肉减少性吞咽困难，和19个没有肌肉减少性吞咽困难。与无肌肉减少性吞咽困难组相比，有肌肉减少性吞咽困难组的舌肌横截面积和亮度面积显著降低。识别少肌性吞咽困难的最特异性因素是舌肌面积（敏感性，0.389;特异性，0.947;截止值，1536.0），而敏感性最高的因素是矢状面颏舌骨肌面积亮度（敏感性，0.806;特异性，0.632;截止值，20.1）。多因素Logistic回归分析显示舌肌面积和舌肌亮面积是少肌性吞咽困难的独立危险因素。然而，颏舌骨矢状肌面积和亮度面积与少肌性吞咽困难无明显独立相关性。结论：少肌性吞咽困难患者舌肌质量小于无少肌性吞咽困难患者。肌性吞咽困难也与舌肌强度增加有关。(C)2017年AMDA -急性后和长期护理医学协会。
Background: Sarcopenic dysphagia is characterized by difficulty swallowing due to a loss of whole-body skeletal and swallowing muscle mass and function. However, no study has reported on swallowing muscle mass and quality in patients with sarcopenic dysphagia.Objective: To compare the differences in swallowing muscle mass and quality between sarcopenic and nonsarcopenic dysphagia.Method: A cross-sectional study was performed in 55 older patients, who had been recommended to undergo dysphagia assessment and/or rehabilitation. Sarcopenic dysphagia was diagnosed using a diagnostic algorithm for sarcopenic dysphagia. The thickness and area of tongue muscle and geniohyoid muscle (coronal plane and sagittal plane), and the echo-intensity of the tongue and geniohyoid muscles were examined by ultrasound.Results: The study participants included 31 males and 24 females (mean age of 82 +/- 7 years), with 14 having possible sarcopenic dysphagia, 22 probable sarcopenic dysphagia, and 19 without sarcopenic dysphagia. The group with sarcopenic dysphagia had a significantly lower cross-sectional area and area of brightness of the tongue muscle than that observed in the group without sarcopenic dysphagia. The most specific factor for identifying the presence of sarcopenic dysphagia was tongue muscle area (sensitivity, 0.389; specificity, 0.947; cut-off value, 1536.0), while the factor with the highest sensitivity was geniohyoid muscle area brightness in sagittal sections (sensitivity, 0.806; specificity, 0.632; cut-off value, 20.1). Multivariate logistic regression analysis showed that the area of the tongue muscle and its area of brightness were independent risk factors for sarcopenic dysphagia. However, geniohyoid sagittal muscle area and area of brightness showed no significant independent association with sarcopenic dysphagia.Conclusion: Tongue muscle mass in patients with sarcopenic dysphagia was smaller than that in patients without the condition. Sarcopenic dysphagia was also associated with increased intensity of the tongue muscle. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.