Objective: This study aimed to explore the effects of fluid hydration status on ultrasound muscle measurement in hemodialysis (HD) patients. Methods: Ultrasound muscle examination of the right rectus femoris and bioelectrical impedance analysis measurement of the right lower limb were performed in HD patients at the periods of predialysis and postdialysis. The correlations between the changes in the corresponding ultrasound and bioelectrical impedance analysis variables were analyzed. Results: A total of 50 patients on maintenance HD were included, with mean age of 52.6 +/- 13.5 years. Patients were 40% female (n=20), and average dialysis duration was 2.62 +/- 2.42 years. Compared to predialysis, the measurements of cross-sectional area, muscle thickness, echo intensity (EI), and their percentage changes all decreased significantly after the HD procedure (P<.05). The change in EI and its percentage change were significantly correlated with changes in total body water, intracellular water, and extracellular water (P<.05). Conclusions: The HD session may have significant effects on ultrasound muscle measurement. Both the indicators of muscle quantity (cross-sectional area and muscle thickness) and quality (EI) significantly decreased after HD, which may contribute to the change in fluid hydration status and the change in fluid composition.

肌少症是一组与年龄相关的疾病,表现为肌肉力量及运动能力减退.肌少症会造成跌倒和骨折风险增加,导致患者运动功能失调、生活质量下降,也是引发患者日常生活能力下降的重要原因[1].肌少症的发生涉及多种风险因素和机制[2,3] ,血液透析患者由于年龄及透析龄增长、运动量不足及营养不良等因素,致使肌少症、自主生活能力失能高发病率[4,5].透析患者丧失独立生活能力,需要别人长期照料,增加血透患者医疗支出费用和死亡风险[6,7].少数民族地区透析患者语言沟通相对困难,医疗费用承受能力差,器械设备较欠缺,依从性相对较差,患者及医护对肌少症和自主生活能力失能及其危害普遍缺乏认识.随着2019年亚洲肌少症指南更新,本研究调查少数民族地区透析患者肌少症患病率以及其危险因素,并评估IADL失能情况,为进一步防治提供前期基础以及依据.

Background Patients on hemodialysis often suffer from reduced muscle strength and exercise capacity due to the decreased quantity and quality of muscle. Cumulative studies showed ultrasound echo intensity (EI) had great potential in evaluating muscle quality. The objective of this study was to evaluate the relationship between EI of skeletal muscle and physical function of patients on maintenance hemodialysis. Methods Cross-sectional area (CSA) and mean EI of the right rectus femoris were measured by ultrasound to evaluate the quantity and quality of the muscle, respectively. Physical function was measured by handgrip strength (HGS), gait speed, sit-to-stand 60 s (STS-60) test, and instrumental activities of daily living (IADL) scale. Results A total of 107 patients on hemodialysis were included, with women accounting for 37.3% ( n = 40), and a mean age of 53.53 ± 12.52 years. Among the patients on hemodialysis, EI was moderately and negatively correlated with HGS ( r = − 0.467, P < 0.001), gait speed ( r = − 0.285, P = 0.003), and STS-60 ( r = − 0.313, P = 0.001). Multiple regression analyses adjusted for CSA showed that the enhanced EI of patients on hemodialysis remained associated with worse HGS (β = − 0.207, P = 0.047), lower gait speed (β = − 0.002, P = 0.001), less STS-60 (β = − 0.136, P = 0.049), and a higher likelihood of dependency in IADL (Odds Ratio: 1.070, 95% CI: [1.033–1.111], P = 0.001). Conclusions In patients on hemodialysis, enhanced EI in the skeletal muscle measured via ultrasound was correlated with poor physical performance. The combined muscle quality and muscle quantity evaluation provide more information for assessing the level of physical function of the patients.