不同诊断标准下急性缺血性脑卒中肌少症患病率研究  

Prevalence of sarcopenia in acute ischemic stroke using different diagnostic criteria

作　　者：陈蕊 廖若彤 罗旺辉 梁好 萧蕙 郭建文 魏琳 CHEN Rui;LIAO Ruotong;LUO Wanghui;LIANG Hao;XIAO Hui;GUO Jianwen;WEI Lin(The Second Clinical School of Medicine Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou 510000,China;College of Nursing,Hunan University of Chinese Medicine,Hunan Province,Changsha 410208,China;Department of Neurology,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou 510120,China;Department of Nursing,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510000 [2]湖南中医药大学护理学院,湖南长沙410208 [3]广州中医药大学第二附属医院神经科,广东广州510120 [4]广州中医药大学第二附属医院护理部,广东广州510120

出　　处：《中国医药导报》2022年第14期121-124,129,共5页China Medical Herald

基　　金：国家自然科学基金面上项目(81974559);广州中医药大学人文社会科学项目一般专项(2021SKYB04)。

摘　　要：目的比较不同诊断标准下急性缺血性脑卒中肌少症患病率,探讨各诊断标准间的一致性及诊断效能。方法选择2020年7月至2021年5月广东省中医院脑病区共117例急性缺血性脑卒中肌少症患者。分别使用亚洲肌少症工作组(AWGS),欧洲老年人肌少症工作组(EWGSOP),国际肌少症工作组(IWGS)和美国国立卫生研究院基金会(FNIH)诊断肌少症。收集患者的一般资料,测量握力、四肢骨骼肌质量,计算体重指数(BMI)等。计算各诊断标准间的一致性、灵敏度和特异度。结果AWGS、EWGSOP、IWGS和FNIH标准下急性缺血性脑卒中肌少症患病率分别是40.2%、33.3%、44.4%和8.5%。其中以AWGS为标准,与EWGSOP一致率为93.16%(Kappa=0.97,P<0.01),灵敏度为100.0%,特异度为89.7%;与IWGS一致率为95.72%(Kappa=0.99,P<0.01),灵敏度为90.4%,特异度为100.0%;与FNIH一致率为64.96%(Kappa=0.06,P<0.01),灵敏度为80.0%,特异度为63.6%。结论IWGS对急性缺血性脑卒中肌少症检出率最高,FNIH检出率明显低于其他3种诊断标准;AWGS、EWGSOP、IWGS对急性缺血性脑卒中肌少症诊断一致性较好,AWGS标准有更好的灵敏度与特异度,FNIH标准与其他3种诊断标准一致性较差。Objective To compare the prevalence of acute ischemic stroke sarcopenia under different diagnostic criteria,and to explore the consistency and diagnostic efficacy of each diagnostic criteria.Methods A total of 117 patients of acute ischemic stroke in the encephalopathy department of Guangdong Provincial Hospital of Traditional Chinese Medicine from July 2020 to May 2021 were selected.Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia(AWGS),the European Working Group on Sarcopenia in the elderly(EWGSOP),the International Working Group on Sarcopenia(IWGS),and the Foundation for the National Institutes of Health(FNIH),respectively.The general data of the patients were collected,grip strength,skeletal muscle mass of limbs were measured,and body mass index(BMI)was calculated.Concordance,sensitivity and specificity between diagnostic criteria were calculated.Results The prevalence of acute ischemic stroke sarcopenia under AWGS,EWGSOP,IWGS,and FNIH criteria were 40.2%,33.3%,44.4%,and 8.5%,respectively.With AWGS as the standard,the consistency rate with EWGSOP was 93.16%(Kappa=0.97,P<0.01),the sensitivity was 100.0%,and the specificity was 89.7%;the concordance rate with IWGS was 95.72%(Kappa=0.99,P<0.01),the sensitivity was 90.4%,and the specificity was 100.0%;the concordance rate with FNIH was 64.96%(Kappa=0.06,P<0.01),the sensitivity was 80.0%,and the specificity was 63.6%.Conclusion IWGS has the highest detection rate of sarcopenia in acute ischemic stroke,and the detection rate of FNIH is significantly lower than the other three diagnostic criteria;AWGS,EWGSOP,and IWGS have good consistency in the diagnosis of acute ischemic stroke sarcopenia,AWGS criteria have better sensitivity and specificity,and FNIH criteria have poor consistency with the other three diagnostic criteria.

关 键 词：脑卒中 肌少症 患病率 诊断标准 

分 类 号：R74[医药卫生—神经病学与精神病学]