老年肺癌患者肌肉量减少与生活质量的相关性研究

摘要

Objective To investigate the relationship between muscle mass reduction and quality of life in elderly lung cancer patients at the initial visit.Methods Totally 221 patients with non-small cell lung cancer undergoing chest and abdominal CT examination were included in this study at Fenyang Hospital in Shanxi Province.The Pearson's correlations of skeletal muscle index(SMI) and skeletal muscle radiodensity(SMD)with the disease stage,physical function,role of physical function,global quality of life,fatigue and dyspnea were analyzed.Results The average age of 221 patients was(70.2t9.0)years.The mean SMI for men and women was(46.7± 7.8)cm2/m2 and(39.4 ±6.4) cm2/m2 respectively.Multivariate linear regression analysis showed that SMI affected the body function,role of physical function,global quality of life,and fatigue dimension(all P ＜ 0.05),and SMD affected the physical function of life quality and dyspnea dimension(P ＜0.05).SMI was related to the physical function and role of physical function(men:r =0.287 and 0.245,P =0.001 and 0.006;women:r=0.296 and 0.395,P =0.004 and 0.000).In male patients,SMO was also associated with low global quality of life and fatigue(r=0.191 and-0.198,P =0.032 and 0.026).The above relationships did not change even after adjusting for the effect of age and disease stages.Low SMD was associated with low physical function and dyspnea in both men and women(men:r =0.287 and 0.245,P=0.037 and 0.049;women.:r=0.281 and-0.262,P=0.006 and 0.010),and SMD was associated with dyspnea only in women even after adjusting for age and disease stages.A correlation between SMI and the disease stage was found in both men and women(male:r =-0.266,P=0.003;female:r=-0.223,P=0.005).Conclusions Changes in muscle mass may affect the physical function,role of physical function and global quality of life in elderly patients with non-small cell lung cancer.%目的 调查肺癌患者诊断之初肌肉量与生活质量之间的关系. 方法 本研究纳入山西省汾阳医院接受过胸腹CT检查的221例非小细胞老年肺癌初诊患者.采用Pearson相关分析,探讨骨骼肌指数(SMI)和骨骼肌肌肉放射密度(SMD)与疾病分期及身体功能、角色功能、整体生活质量、疲乏、呼吸困难间的关系. 结果 221例患者年龄(70.2±9.0)岁,男女SMI均值分别为(46.7±7.8)cm2/m2,(39.4±6.4)cm2/m2.多元线性回归分析显示SMI影响生活质量的身体功能、角色功能、整体生活质量、疲乏维度(均P＜0.05),SMD影响生活质量的身体功能、呼吸困难维度(均P＜0.05).SMI与身体功能、角色功能相关(男:r=0.287、0.245,P=0.001、0.006,女:r=0.296、0.395,P=0.004、0.000),男性患者SMI还与低整体生活质量、疲乏相关(r=0.191、-0.198,P=0.032、0.026),调整年龄和疾病分期影响后这些变量间的关系没有发生改变.低SMD与低身体功能和呼吸困难相关(男:r=0.186、-0.172,P=0.037、0.049,女:r=0.281、-0.262,P=0.006、0.010),调整年龄和疾病分期影响后只有女性患者的SMD与呼吸困难相关.SMI与疾病分期之间都存在相关性(男:r=-0.266,P=0.003,女:r=-0.223,P=0.005). 结论 肌肉量的改变可能会影响老年肺癌患者的身体功能、角色功能和整体生活质量.