4种社区肌少症筛查工具对维持性血液透析合并肌少症病人应用效度比较  

Comparison of the validity of 4 community sarcopenia screening tools for MHD sarcopenia patients

作　　者：马原 吴银银 窦俊凯 万菁菁 吴芳 武仪冉 焦敏 陶明芬[3] 王翠珍[3] 陶秀彬[3] MA Yuan;WU Yinyin;DOU Junkai;WAN Jingjing;WU Fang;WU Yiran;JIAO Min;TAO Mingfen;WANG Cuizhen;TAO Xiubin(Graduate School,Wannan Medical College,Anhui 241002 China)

机构地区：[1]皖南医学院研究生学院,安徽241002 [2]安徽中医药大学研究生学院 [3]皖南医学院弋矶山医院

出　　处：《护理研究》2022年第16期2886-2891,共6页Chinese Nursing Research

基　　金：2020年度安徽高校人文社会科学研究项目,编号:SK2020ZD34。

摘　　要：目的:探讨最适用于维持性血液透析(MHD)合并肌少症筛查的工具,为早期诊断及其干预提供理论支持。方法:选取2021年9月—2021年11月在安徽省芜湖市某三级甲等医院血液净化中心治疗的164例MHD病人为研究对象,采用Ishii评分、中文版肌少症五条目量表(SARC⁃F)、肌少症五条目联合小腿围量表(SARC⁃Calf)和肌少症五条目结合老龄和体质指数量表(SARC⁃F+EBM)进行筛检,以2019亚洲肌少症诊断策略为诊断标准,计算Ishii评分、中文版SARC⁃F量表、SARC⁃Calf和SARC⁃F+EBM量表的灵敏度、特异度、阳性预测值、阴性预测值、约登指数、Kappa值及ROC曲线下面积(AUC)。结果:MHD病人合并肌少症的发生率为29.27%,Ishii评分、中文版SARC⁃F量表、SARC⁃Calf量表和SARC⁃F+EBM量表诊断的灵敏度分别为89.58%、25.00%、70.83%、62.50%,特异度分别为78.45%、96.55%、81.90%、88.79%,阳性预测值分别为63.23%、75.00%、61.82%、69.77%,阴性预测值分别为94.79%、75.68%、87.16%、85.12%;AUC分别为0.890,0.760,0.822,0.836。结论:在MHD人群中,Ishii评分较其他3种社区肌少症筛查工具有更高的应用价值。Objective:To explore the most suitable tools for screening sarcopenia in maintenance hemodialysis(MHD),in order to provide theoretical support for early diagnosis and intervention.Methods:From September 2021 to November 2021,a total of 164 MHD patients who were treated in a blood purification center of a tertiary grade A hospital in Wuhu city,Anhui province,were selected as the research subjects.Ishii Score(IS),the Chinese version of the Sarcopenia⁃Five(SARC⁃F)scale,SARC⁃F combined with calf circumference(SARC⁃calf)scale,and SARC⁃F combined with Elderly and BMI(SARC⁃F+EBM)scale were used for screening.The latest 2019 Asian Working Group for Sarcopenia 2019(AWGS 2019)was used as the diagnostic criteria to calculate scores of sensitivity,specificity,positive predictive value,negative predictive value,Youden index,Kappa value and area under the ROC curve(AUC)of IS and Chinese version SARC⁃F scale,SARC⁃Calf scale,and SARC⁃F+EBM scale.Results:The incidence of sarcopenia in MHD patients was 29.27%.The diagnostic sensitivity of IS,Chinese version SARC⁃F scale,SARC⁃calf scale and SARC⁃F+EBM scale were 89.58%,25.00%,70.83%,62.50%,respectively;specificity were 78.45%,96.55%,81.90%,88.79%,respectively;positive predictive value were 63.23%,75.00%,61.82%,69.77%,respectively;negative predictive value were 94.79%,75.68%,87.16%,85.12%,respectively;AUC were 0.890,0.760,0.822,0.836,respectively.Conclusions:The IS had a higher application value in the MHD population than the other three community sarcopenia screening tools.

关 键 词：肌少症 筛查工具 维持性血液透析 灵敏度 特异度 护理 

分 类 号：R473[医药卫生—护理学]