Preoperative myopenia and myosteatosis and their impact on postoperative complications in children with inflammatory bowel disease
Preoperative myopenia and myosteatosis and their impact on postoperative complications in children with inflammatory bowel disease
复制标题
DOI：
10.1007/s00595-022-02596-3
复制
发表时间：
2022-10-11
期刊：
影响因子：
2.5
通讯作者：
Toiyama, Yuji
中科院分区：
文献类型：
--
作者：
Inoue, Mikihiro;Uchida, Keiichi;Toiyama, Yuji
目的评估儿童炎症性肠病（IBD）患者术前肌减少和肌骨增生的严重程度，并探讨其对术后并发症的影响。方法回顾性研究对象为30例IBD患儿（22例溃疡性结肠炎（UC）， 8例克罗恩病（CD））和67例年龄匹配的对照组。比较两组患者术前体重指数（BMI）、腰肌指数（PMI）和肌内脂肪组织含量，探讨其与术后并发症的关系。结果IBD组BMI和PMI均显著低于对照组（p < 0.0001, p < 0.0001）。与UC相比，CD与较低的BMI和PMI相关（p = 0.01, p = 0.01）。肌内脂肪组织含量在IBD患者和对照组以及UC和CD患者之间具有可比性。这三个指标在IBD患者术后并发症的存在与否方面没有显著差异。当仅限于手术部位感染（SSI）时，只有SSI患者的PMI显著低于无SSI患者（p = 0.04）。结论：尽管儿童IBD患者术前BMI和PMI低于对照组，但只有肌萎缩似乎会影响SSI的发展。
Purpose To assess the severity of preoperative myopenia and myosteatosis in pediatric patients with inflammatory bowel disease (IBD) and examine their impact on postoperative complications. Methods The subjects of this retrospective study were 30 pediatric patients with IBD (22 with ulcerative colitis (UC) and 8 with Crohn's disease (CD)) and 67 age-matched controls. Preoperative body mass index (BMI), psoas muscle index (PMI), and intramuscular adipose tissue content were compared between the patient groups, to investigate their association with postoperative complications. Results BMI and PMI were significantly lower in the IBD patients than in the controls (p < 0.0001, p < 0.0001, respectively). CD was associated with significantly lower BMI and PMI (p = 0.01, p = 0.01, respectively) than UC. Intramuscular adipose tissue content was comparable between the IBD patients and the controls and between the UC and CD patients. There were no significant differences among the three indices in relation to the presence or absence of postoperative complications in patients with IBD. When limited to surgical site infection (SSI), only PMI was significantly lower in the patients with SSI than in those without SSI (p = 0.04). Conclusions Although BMI and PMI were lower preoperatively in pediatric IBD patients than in controls, only myopenia seemed to affect the development of SSI.