Changes in Quadriceps Muscle Thickness, Disease Severity, Nutritional Status, and C-Reactive Protein after Acute Stroke
Changes in Quadriceps Muscle Thickness, Disease Severity, Nutritional Status, and C-Reactive Protein after Acute Stroke
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急性中风后股四头肌厚度、疾病严重程度、营养状况和 C 反应蛋白的变化
DOI：
10.1016/j.jstrokecerebrovasdis.2016.06.020
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Shimada S.
中科院分区：
文献类型：
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作者：
Nozoe M;Kanai M;Kubo H;Kitamura Y;Yamamoto M;Furuichi A;Takashima S;Mase K;Shimada S.
背景小腿肌肉萎缩在中风患者中很常见；然而，很少研究急性期患者的特征。本研究旨在探讨急性脑卒中后股四头肌厚度变化与疾病严重程度、营养状况和C反应蛋白（CRP）水平之间的关系。方法连续31例急性脑出血或缺血性脑卒中患者入院后1周（第一周）和首次检查后2周（最后一周）使用超声检查测量偏瘫和非偏瘫肢体的股四头肌厚度。我们还确定了入院时肌肉厚度百分比变化与疾病严重程度、营养状况和 CRP 水平之间的关系。结果 偏瘫侧和非偏瘫侧的肌肉厚度变化与美国国立卫生研究院卒中量表 (NIHSS) 评分之间存在显着相关性（偏瘫肢体：r= −.46，P= .01；非偏瘫肢体：r= −.54，P= .002）；然而，与入院时的营养状况没有显着相关性。 CRP 阳性 (≥.3 mg/dL) 患者的股四头肌厚度比 CRP 阴性 (<.3 mg/dL) 患者的非麻痹肢体的股四头肌厚度减少更多（阳性：-21.4 ± 12.1，阴性：-11.4 ± 16.4%；P= .039），但麻痹肢体则不然（阳性： −23.4 ± 9.0，阴性：-19.1 ± 15.7；P= .27）。结论 NIHSS 高评分和入院时 CRP 阳性均与急性卒中后股四头肌厚度下降显着相关。这些患者入院时的营养状况与股四头肌厚度的变化无关。
BackgroundLower leg muscle wasting is common in stroke patients; however, patient characteristics in the acute phase are rarely studied. This study aimed to examine the relationship between changes in quadriceps muscle thickness and disease severity, nutritional status, and C-reactive protein (CRP) levels after acute stroke.MethodsThirty-one consecutive patients with acute intracerebral hemorrhage or ischemic stroke had quadriceps muscle thickness measured in the paretic and nonparetic limbs within 1 week after admission (first week) and 2 weeks after the first examination (last week) using ultrasonography. We also determined the relationship between the percentage change in muscle thickness and disease severity, nutritional status, and CRP levels on admission.ResultsThere was a significant correlation between changes in muscle thickness for both paretic and nonparetic sides and National Institutes of Health Stroke Scale (NIHSS) scores (paretic limb:r= −.46,P= .01; nonparetic limb:r= −.54,P= .002, respectively); however, there was no significant correlation with nutritional status on admission. Quadriceps muscle thickness was reduced more in the CRP-positive (≥.3 mg/dL) patients than in the CRP-negative (<.3 mg/dL) patients in the nonparetic limb (positive: −21.4 ± 12.1, negative: −11.4 ± 16.4%;P= .039), but not in the paretic limb (positive: −23.4 ± 9.0, negative: −19.1 ± 15.7;P= .27).ConclusionsA high NIHSS score and a positive CRP on admission were both significantly correlated with decreased quadriceps muscle thickness after acute stroke. Nutritional status on admission was not correlated with changes in quadriceps muscle thickness for these patients.