Pacientes com diagnóstico de cirrose hepática apresentam prejuízo na resistência muscular periférica e inspiratória: estudo transversal

Abstract

INTRODUCTION: Patients with hepatic cirrhosis present impairment in the synthesis of energetic substrates for muscle tissue. Many factors can explain the reduction of muscle mass but the protein energy malnutrition being the main factor. This changes can compromise all skeletal muscles, both peripheral and respiratory. Reduction of muscle mass leads to persistent muscle fatigue, resulting in a deficit in functional status and quality of life. In view of this scenario, knowing that patients with liver cirrhosis present metabolic alterations that may lead to early global muscle fatigue, it is justified to evaluate both peripheral and inspiratory muscle endurance in these patients. OBJECTIVES: Test the hypothesis that patients with hepatic cirrhosis (HCG) have lower peripheral and inspiratory muscle resistance compared to those without a diagnosis of hepatic cirrhosis (CG). METHODS: A cross-sectional observational study with a convenience sample consisting of a group of patients diagnosed with liver cirrhosis (HCG, n=19 61±14 years) and a control group of subjects without hepatic cirrhosis (CG, n=17 56±17 years). All volunteers (HCG and CG) underwent quality of life assessment (CLDQ-BR), anthropometric measures body mass (Líder®, Brazil), waist and arm circumference (Sanny®), blood pressure (Dixtal® model 2022), heart rate (Dixtal®, model 2022), respiratory rate (observation of thoracic expansion) and peripheral oxygen saturation at rest (Dixtal®, model 2022), maximum hand gripper force (hand hold dynamometer, EGM ), Maximal inspiratory and expiratory force (maximal respiratory pressures, MVD300 GlobalMed® manovacuometer), peripheral muscle resistance and inspiratory muscle resistance. For statistical analysis, the Shapiro-Wilk, Chi-square, Fisher's exact test, Student's t test, "d" Cohen and Pearson's correlation were performed. It was adopted as significant difference P≤0,05. RESULTS: HCG presented lower peripheral and inspiratory muscle resistance when compared to CG (66 ± 39s vs. 131 ± 56s p = 0.0003 and 40 ± 15s vs. 112 ± 49s p = 0.0000002, respectively). Peripheral muscle resistance showed a positive correlation with the total quality of life and with the domains of fatigue, activity, systemic symptoms and concern. The inspiratory muscular endurance showed a positive correlation with total quality of life and the domains fatigue, activity, systemic symptoms, abdominal symptoms, emotional function and concern. Peripheral muscle resistance showed a positive correlation with inspiratory muscle resistance. CONCLUSION: Patients with liver cirrhosis have lower peripheral muscle resistance and lower inspiratory muscle resistance than individuals who do not have such pathology.