多模态干预策略对老年合并慢病肌少症患者的临床疗效评价

王 玉, 李 伟, 孙 玉玲, 丁 洁琼, 刘 婷, 李淑 玲*
淮北市人民医院老年医学科

摘要


目的：探讨血清25羟维生素D（25（OH）D）水平干预联合渐进式抗阻训练及个体化营养干预对老年合并慢病肌少症患者肌肉代谢稳态的影响。方法：采用简单随机化法，纳入90例老年合并慢病的肌少症且维生素D缺乏（25（OH）D≤18.8ng/mL）患者，随机分为三组：T1组（基础疾病管理+健康宣教，n=30例）、T2组（结构化抗阻训练加维生素D补充，n=30例）、T3组（T2方案+个性化营养支持，n=30例）。干预3个月，观察血清25（OH）D）水平、握力、6米步速、5次起坐时间及日常生活能力（ADL）评分。结果：干预后，T3组血清25（OH）D水平（18.27±3.38ng/mL）显著高于T1组（14.80±2.62ng/mL，P＜0.05）；T2组、T3组握力分别提升至（20.81±0.98）kg和（21.70±1.12）kg，均较基线显著增加（P＜0.05），且T3组提升幅度优于T1组（P＜0.05）。T3组6米步速（0.84±0.04m/s）、5次起坐时间（12.60±0.78s）及ADL评分（92.00±1.71分）均显著优于其他组（P＜0.05）。结论：维生素D补充、抗阻训练联合营养干预的多模态策略可显著改善老年肌少症患者的肌肉功能及代谢稳态，联合营养干预方案效果最优。

关键词


老年慢性病；肌少症；维生素D；营养干预；抗阻训练

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参考


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