Respiratory Muscle Weakness as a Risk Factor for Pneumonia in Older People
Respiratory Muscle Weakness as a Risk Factor for Pneumonia in Older People
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DOI：
10.1159/000514007
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发表时间：
2021-02-23
期刊：
影响因子：
3.5
通讯作者：
Ebihara, Takae
中科院分区：
文献类型：
--
作者：
Okazaki, Tatsuma;Suzukamo, Yoshimi;Ebihara, Takae
简介：呼吸肌的力量调节咳嗽的有效性，从而清除气道，保护人们免受肺炎。肌肉减少症是一种与年龄相关的肌肉质量和功能丧失，其恶化与营养不良有关。随着年龄的增长，呼吸和吞咽肌肉的力量会下降，但其对肺炎的影响尚不清楚。本研究旨在确定呼吸肌无力对老年人肺炎发作和复发的风险，以及其他肌肉相关因素，如营养不良。方法：我们对47例肺炎住院患者和35例70岁及以上非肺炎对照者进行了纵向研究。我们评估了呼吸和吞咽肌肉的力量，肌肉质量和营养不良（通过血清白蛋白水平和体脂肪评估），并在6个月内确认肺炎复发。最大吸气压和最大呼气压决定了呼吸肌力。通过舌压评价吞咽肌力。生物电阻抗分析用于评估肌肉和脂肪质量。结果如下：肺炎患者呼吸肌肌力、躯干肌质量、血清白蛋白水平、体脂肪质量和舌压均显著低于对照组。发生肺炎的危险因素是低吸气呼吸肌强度（比值比[OR]，6.85; 95%置信区间[CI]，1.56-30.11），低躯干肌肉质量除以身高（2）（OR，6.86; 95% CI，1.49-31.65）和低血清白蛋白水平（OR，5.46; 95% CI，1.51-19.79）。对于肺炎复发，低体脂肪量除以身高（2）是一个危险因素（OR，20.10; 95%CI，2.10-192.42）。讨论/结论：呼吸肌无力、下半身躯干肌肉质量和营养不良是老年人肺炎发病的危险因素。对于肺炎复发，营养不良是一个危险因素。
Introduction: The respiratory muscle strength regulates the effectiveness of coughing, which clears the airways and protects people from pneumonia. Sarcopenia is an aging-related loss of muscle mass and function, the worsening of which is associated with malnutrition. The loss of respiratory and swallowing muscle strength occurs with aging, but its effect on pneumonia is unclear. This study aimed to determine the risks of respiratory muscle weakness on the onset and relapse of pneumonia in older people in conjunction with other muscle-related factors such as malnutrition. Methods: We conducted a longitudinal study with 47 pneumonia inpatients and 35 non-pneumonia controls aged 70 years and older. We evaluated the strength of respiratory and swallowing muscles, muscle mass, and malnutrition (assessed by serum albumin levels and somatic fat) during admission and confirmed pneumonia relapse within 6 months. The maximal inspiratory and expiratory pressures determined the respiratory muscle strength. Swallowing muscle strength was evaluated by tongue pressure. Bioelectrical impedance analysis was used to evaluate the muscle and fat mass. Results: The respiratory muscle strength, body trunk muscle mass, serum albumin level, somatic fat mass, and tongue pressure were significantly lower in pneumonia patients than in controls. Risk factors for the onset of pneumonia were low inspiratory respiratory muscle strength (odds ratio [OR], 6.85; 95% confidence interval [CI], 1.56-30.11), low body trunk muscle mass divided by height(2) (OR, 6.86; 95% CI, 1.49-31.65), and low serum albumin level (OR, 5.46; 95% CI, 1.51-19.79). For the relapse of pneumonia, low somatic fat mass divided by height(2) was a risk factor (OR, 20.10; 95% CI, 2.10-192.42). Discussion/Conclusions: Respiratory muscle weakness, lower body trunk muscle mass, and malnutrition were risk factors for the onset of pneumonia in older people. For the relapse of pneumonia, malnutrition was a risk factor.