三种肌少症筛查工具在社区老年糖尿病患者肌少症筛查中的应用研究  

Application of 3 Screening Tools for Sarcopenia in Elderly Patients with Diabetes Mellitus in Community

作　　者：唐志芬 韩文娟 杨旻星 叶赟[1] TANG Zhifen;HAN Wenjuan;YANG Minxing;YE Yun(Department of Endocrinology and Metabolism,The First People’s Hospital of Changzhou,Changzhou 213000,Jiangsu Province,China)

机构地区：[1]常州市第一人民医院内分泌代谢科,江苏常州213000

出　　处：《军事护理》2023年第10期21-24,共4页MILITARY NURSING

基　　金：常州市“十四五”卫生健康高层次人才培养工程-拔尖人才(2022260);常州市卫生健康青苗人才培养工程(CZQM2020020);常州市第一人民医院护理专项预研基金(yy2020006)。

摘　　要：目的探讨适用于社区老年糖尿病患者筛查肌少症的工具,为该类患者早发现、早干预提供依据。方法2021年6月至2022年5月,采用方便抽样法选取常州市两个社区中老年糖尿病患者150名为研究对象,分别采用肌肉减少症五条目量表(strength,assistance in walk,rise from chair,climb stairs,fall,SARC-F)、肌肉减少症五条目联合小腿围量表(SARC-F combined with calf circumference,SARC-CalF)、指环测试进行筛查,以2019年亚洲肌少症工作组(Asia Working Group for Sarcopenia,AWGS 2019)诊断共识中的肌少症诊断切点为金标准,计算SARC-F、SARC-CalF、指环测试的敏感度、特异度、阳性预测值、阴性预测值、Kappa值及受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under curve,AUC)。结果150名社区老年糖尿病患者中,有34例肌少症,患病率为22.7%。按有无肌少症进行分组,两组患者在病程、体质量指数、吸烟史、小腿围、5次起坐时间等项目上的差异均有统计学意义(均P<0.05)。SARC-F、SARC-CalF、指环测试诊断敏感度分别为34.4%、46.9%、87.5%;特异度分别为90.7%、91.7%、77.8%;阳性预测值分别为52.4%、62.5%、53.8%;AUC分别为0.626、0.693、0.826。结论指环测试比SARC-F、SARC-CalF具有更好的预测价值,且不需借助其他工具,方便、快捷,可推荐为此类社区人群肌少症的快速筛查工具。Objective To explore the screening tools for sarcopenia in the community of elderly patients with diabetes mellitus,and to provide a basis for early detection and early interventionin community.Methods From June 2021 to May 2022,the convenience sampling method was used to select 150 elderly diabetic patients in 2 communities of Changzhou as the research objects.The five-item sarcopenia scale(strength,assistance in walk,rise from chair,climb stairs,fall,SARC-F),SARC-F combined with calf circumference(SARC-CalF),and finger ring test were used for screening.Using the 2019 Asia Working Group for Sarcopenia(AWGS 2019)diagnostic consensus for sarcopenia as the gold standard,sensitivity,specificity,positive predictive value,negative predictive value,Kappa value and receiver operating characteristic(ROC)of the area under curve(AUC)of SARC-F,SARC-CalF and finger ring test were calculated.Results Among 150 elderly diabetic patients in the community,there were 34 cases of sarcopenia,and the prevalence rate was 22.7%.There were significant differences between the two groups in the course of disease,body mass index,smoking history,calf circumference,and the time to sit and stand for five times(all P<0.05).The diagnostic sensitivity of SARC-F,SARC-CalF and finger ring test were 34.4%,46.9%and 87.5%,respectively.The specificity were 90.7%,91.7%and 77.8%,respectively.The positive predictive values were 52.4%,62.5%and 53.8%,respectively.The AUC were 0.626,0.693 and 0.826,respectively.Conclusion The finger ring test has better predictive value than SARC-F and SARC-CalF in screening for sarcopenia in elderly diabetic patients in community.It is convenient and fast,and can be recommended as a rapid screening tool for sarcopenia in this community population.

关 键 词：糖尿病 肌少症 肌肉减少症五条目量表 肌肉减少症五条目联合小腿围量表 指环测试 敏感度 特异度 

分 类 号：R473.2[医药卫生—护理学]