COPD患者肌肉衰减综合征发病现状及风险评估模型构建  

Prevalence of muscle wasting syndrome in COPD patients and the establishment of a risk assessment model

作　　者：邓燕[1] 李莉[2] 张红丽[1] 裴华莲[1] Deng Yan;Li Li;Zhang Hongli;Pei Hualian(RICU,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院RICU,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院泌尿外三科,新疆乌鲁木齐830054

出　　处：《护理学杂志》2020年第22期19-24,共6页Journal of Nursing Science

基　　金：新疆维吾尔自治区自然科学基金项目(2017D01C288)。

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)患者肌肉衰减综合征的发病现状及影响因素,并建立风险诊断模型。方法对225例COPD患者进行问卷调查及骨骼肌含量、力量及运动功能的体格测量。描述及对比分析不同特征患者肌肉衰减综合征分布情况,风险模型构建采用多因素Logistic回归分析并绘制列线图,计算各诊断模型的受试者工作特征曲线下面积进行验证。结果225例COPD患者肌肉衰减综合征前期、衰减期及严重衰减期的比例分别为44.00%,13.78%,5.33%。肌肉衰减综合征中肌肉含量降低的比例最高(占63.11%)。多因素风险诊断模型构建结果显示骨骼肌含量、力量、运动功能共同的危险因素为:每日更少的膳食蛋白量,轻、中度体力活动水平及COPD分级的C级与D级。每日膳食蛋白量、体力活动水平及COPD分级对肌肉衰减综合征的诊断价值分别为0.954、0.917、0.860。结论COPD患者的蛋白摄入、疾病分级及体力活动水平与肌肉衰减综合征密切相关,应采取精准评估及综合干预,有效预防及延缓肌肉衰减综合征的发生发展,提高患者健康水平。Objective To explore the current situation and influencing factors of muscle attenuation syndrome(MAS)in patients with chronic obstructive pulmonary disease(COPD),and to establish a risk assessment model.Methods Totally,225 COPD patients were recruited,surveyed and subjected to physical measurement of skeletal muscle mass,strength and motor function.The distribution of MAS stages,and the distribution of each MAS component in patients with different characteristics were described and compared.Then risk assessment models were built based on multivariate Logistic regression analysis,and a nomogram of the model was drawn.The area(AUC)under the receiver operator characteristic(ROC)curve was used to verify each diagnosis model.Results The proportion of COPD patients in prophase,attenuation and severe attenuation stages of MAS were 44.00%,13.78%and 5.33%,respectively.Among the three MAS components,the muscle mass reduction had the largest share of 63.11%.Based on multivariate Logistic regression analysis,the three MAS components(muscle mass,muscle strength,motor function)shared common risk factors:less dietary protein per day,mild and moderate physical activity level,and COPD stage of C and D.The AUC values of daily dietary protein,physical activity level and COPD stages for three MAS components were 0.954,0.917 and 0.860,respectively.Conclusion Daily dietary protein intake,COPD stages,and physical activity level of COPD patients are closely related to MAS.We should take precise evaluation and comprehensive intervention to effectively prevent and delay the occurrence and development of MAS,so as to improve the health level of COPD patients.

关 键 词：慢性阻塞性肺疾病 骨骼肌 肌肉衰减综合征 肌肉含量 肌肉力量 运动功能 体力活动水平 

分 类 号：R473.5[医药卫生—护理学]