目的 研究 β-羟基-β-甲基丁酸(HMB)对肝硬化患者的肌肉质量、营养状况的影响。 方法 选择 2021 年 8 月至 2022 年 8 月于重庆市大足区人民医院收治的符合入选标准的肝硬化患者。 采用便利抽签法随机将其分为对照组( n = 30)与 试验组(n = 30),两组患者均给予保肝、降酶、营养治疗等常规治疗。 试验组在对照组治疗的基础上加用口服营养补充剂(富 含 HMB)进行治疗。 对比两组患者在 3 个时间点(0 周、3 周、6 周)的体重、白蛋白、握力、骨骼肌质量参数(SMI)、 肱三头肌皮 褶厚度(TSF)、上臂肌围(AMC)、肝功能 Child-Pugh 分级、Barthel 指数评分情况。 结果 试验组患者的体重和 SMI、白蛋白都明 显增高,且两组之间的差异具有统计学意义(P<0. 05)。 两组 TSF、AMC 都有所下降,但两组差异无统计学意义(P>0. 05)。 两 组的肝功能 Child-Pugh 分级、Barthel 指数差异无统计学意义(P>0. 05 )。 结论 肝硬化患者因代谢合成受损,肌肉减少症较常见,本研究通过对肝硬化患者给予 HMB 营养制剂干预,发现在一定程度上能改善骨骼肌的功能及机体的营养状态;抑制肌肉 和蛋白质分解,增加患者的肌肉质量,但没有改善肝功能的损伤程度及个人自理能力。

Objective Research β-hydroxy-β-methylbutyrate HMB on muscle quality and nutritional status of patients with liver cirrhosis. Method The patients with cirrhosis who met the inclusion criteria were selected from August 2021 to August 2022. They were randomly divided into control group n = 30 and test group n = 30 . Both groups were given routine treatment such as liver protection enzyme lowering and nutritional treatment. On the basis of the treatment in the control group the experimental group was treated with oral nutritional supplements rich in HMB . The body weight albumin grip strength skeletal muscle index SMI triceps skinfold thickness TSF arm muscle circumference AMC liver function Child-Pugh grade and Barthel index score of the two groups were compared at three time points 0 3 and 6 weeks . Result The body weight and SMI albumin of patients in the test group were significantly increased and the difference between the two groups was statistically significant P<0. 05 . TSF and AMC decreased in both groups However there was no significant difference between the two groups P>0. 05 . There was no significant difference in Child-Pugh liver function grading and Barthel index between the two groups P>0. 05 . Conclusion Myopenia is more common in patients with liver cirrhosis due to the damage of metabolism and synthesis. This study found that HMB nutrition can improve the function of skeletal muscle and the nutritional status of the body to a certain extent through the intervention of liver cirrhosis patients Inhibit the decomposition of muscle and protein increase the muscle quality of patients but do not improve the damage degree of liver function and personal self-care ability.