心衰竭病人之握力、骨骼肌質量和心肺適能之關係

高齡化社會中隱含著肌少症的患者，在心臟衰竭族群合併肌少症者約占20%，遠比一般族群盛行率高。在疾病表現方面，肌少症的核心症狀是肌肉量減少和肌力下降，而心臟衰竭病人的核心症狀則是運動耐受性降低，目前對於肌肉量、肌力和心肺適能三者之間的關聯性仍不清楚。本研究旨在探討心臟衰竭族群中，握力、骨骼肌質量指數與心肺適能之關係。共收集42位慢性穩定之男性心衰竭病人進行橫斷面研究，另外收取9位年齡相當的健康受試者。他們均接受握力、多頻生物阻抗體組成分析、心肺運動測試、最大吸氣壓力及心臟超音波檢查。病人的數據分別依照握力和骨骼肌質量指數的大小分成低、中和高三組。結果顯示在低握力組在各項心肺適能參數均比中握力組差，包括尖峰攝氧量和尖峰作功率；然而中高握力組則無差異。此外，低、中、高骨骼肌質量指數的低中或中高組間，都未呈現差異。研究結論是，握力有機會作為心衰竭族群的篩檢工具，握力下降至一定程度，可反映心肺適能下降，需要盡早復健。

關鍵字

心衰竭；肌少症；握力；體組成；骨骼肌質量

並列摘要

The prevalence of sarcopenia is approximately 20% among patients with chronic heart failure, which is much higher than that among the general population. The core symptoms of sarcopenia are decreased muscle strength and skeletal muscle mass, whereas the primary symptom of sarcopenia in patients with heart failure is exercise intolerance. The relationships between handgrip strength, skeletal muscle mass, and cardiopulmonary fitness remain unclear and were investigated in the current study. The study included 42 male patients with chronic stable heart failure and 9 healthy individuals of a similar age. All participants underwent handgrip strength testing, multifrequency bioelectrical impendence analysis, cardiopulmonary exercise testing, maximal inspiratory pressure evaluation, and echocardiography. The patients with heart failure were divided into three groups each according to their handgrip strength and appendicular skeletal muscle index (ASMI). The low-handgrip-strength group demonstrated poorer performance on the cardiopulmonary exercise tests, such as in terms of peak V̇ O2 and peak work rate, whereas no significant difference was observed between the mid- and high-handgrip-strength groups. No between-group differences were noted among the three ASMI groups. We conclude that handgrip strength is a simple, convenient, and reliable indicator for sarcopenia screening of patients with heart failure. Cardiopulmonary fitness begins to decline when handgrip strength drops to a certain level.

並列關鍵字

heart failure ； sarcopenia ； hand grip ； body composition ； appendicular skeletal muscle

國際替代計量

心衰竭病人之握力、骨骼肌質量和心肺適能之關係

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