延边大学医学学报

目的：探讨肌少症在老年慢性阻塞性肺疾病(COPD)患者中的发生情况，并分析其与病情严重程度分级、临床症状及急性加重风险的关系。方法：前瞻性纳入2021年1月至2023年12月北京市仁和医院收治的312例老年稳定期COPD患者及在北京市仁和医院进行体检的100例健康人。将COPD患者作为COPD组，将健康人作为对照组。对两组进行肺功能检查、临床症状评估、急性加重史记录等。依据亚洲标准诊断肌少症。结果：COPD组第三腰椎骨骼肌指数(L₃-SMI)低于对照组，肌少症发生率高于对照组(P<0.05)。随着全球慢性阻塞性肺疾病倡议(GOLD)分级的升高，患者肌少症的发生率逐渐上升。不同GOLD分级患者肌少症的发生率对比，差异有统计学意义(P<0.05)。在不同GOLD分组中，从A组到D组，患者肌少症发生率、慢性阻塞性肺疾病测试(CAT)评分及年急性加重≥2次的患者占比逐渐升高(P<0.05)。结论：肌少症在老年COPD患者中普遍存在，发生率与GOLD分级和分组呈正相关。

Objective: To investigate the occurrence of sarcopenia in elderly patients with chronic obstructive pulmonary disease(COPD) and analyze its relationship with disease severity grading, clinical symptoms, and the risk of acute exacerbation. Methods: A total of 312 elderly patients with stable COPD admitted to Beijing Renhe Hospital from January 2021 to December 2023 and 100 healthy individuals undergoing physical examinations at Beijing Renhe Hospital were prospectively enrolled. The COPD patients were assigned to the COPD group, and the healthy individuals were assigned to the control group. Pulmonary function tests, clinical symptom assessments, and records of acute exacerbation history were performed for both groups. Sarcopenia was diagnosed based on Asian criteria. Results: The third lumbar vertebral skeletal muscle index(L₃-SMI) in the COPD group was lower than that in the control group, and the incidence of sarcopenia was higher than that in the control group(P < 0.05). The incidence of sarcopenia gradually increased with the elevation of the Global Initiative for Chronic Obstructive Lung Disease(GOLD) grading. The comparison of the incidence of sarcopenia among patients with different GOLD grades showed statistically significant differences(P < 0.05). Among different GOLD groups, from Group A to Group D, the incidence of sarcopenia, COPD Assessment Test(CAT) scores, and the proportion of patients with ≥2 acute exacerbations per year gradually increased(P < 0.05). Conclusion: Sarcopenia is prevalent in elderly patients with COPD, and its incidence is positively correlated with GOLD grading and grouping.