基于定量CT研究维持性透析患者腹部肌肉成分与腹主动脉钙化的相关性  

Correlation of abdominal muscle composition and abdominal aortic calcification in maintenance dialysis patients based on quantitative CT

作　　者：詹昊 陈其春[1,2] 刘田田 张岱 王龙胜 ZHAN Hao;CHEN Qichun;LIU Tiantian;ZHANG Dai;WANG Longsheng(Department of Radiology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China;Medical Imaging Research Center,Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院放射科,安徽合肥230601 [2]安徽医科大学医学影像研究中心,安徽合肥230601

出　　处：《实用放射学杂志》2024年第3期439-442,455,共5页Journal of Practical Radiology

基　　金：安徽医科大学校科研基金资助项目(2023xkj164)。

摘　　要：目的利用定量CT(QCT)测量维持性透析患者腹部肌肉成分并分析其与腹主动脉钙化(AAC)之间的关系.方法回顾性分析193例维持性透析患者的腹部CT资料,并收集其临床资料.利用QCT测量L3椎体中部层面腹部肌肉成分,包括肌肉面积,肌肉脂肪面积;利用Agatston法计算AAC积分(AACs),根据AACs四分位进行分组,比较4组间肌肉面积、肌肉脂肪面积及其相关变量的差异,采用Spearman秩相关分析和偏相关分析评估腹部肌肉成分与AAC的关系.结果AACs与年龄、男性、透析龄、糖尿病、高血压、腹部肌肉脂肪面积呈正相关(r=0.555、0.172、0.192、0.348、0.335、0.358,P均<0.05),而与腹部肌肉面积无显著相关性.控制年龄、性别、透析龄、高血压、糖尿病因素进行偏相关分析显示,AACs与腹部肌肉脂肪面积仍呈正相关(r=0.183,P=0.012).结论维持性透析患者腹部肌肉脂肪面积与AAC程度呈正相关,高腹部肌肉脂肪面积是AAC的危险因素.加强肌肉锻炼可以预防透析患者血管钙化风险.Objective To measure the abdominal muscle composition of maintenance dialysis patients using quantitative computed tomography(QCT)and to analyze its relationship with abdominal aortic calcification(AAC).Methods The abdominal CT data of 193 maintenance dialysis patients were analyzed retrospectively and their clinical data were collected.The abdominal muscle composi-tion,including muscle area and muscle fat area,was measured at the middle level of L3 vertebral by QCT.The abdominal aortic calcifica-tion scores(AACs)were calculated using the Agatston method.The groups were grouped according to the quartiles of AACs,and differences in muscle area,muscle fat area and their associated variables were compared between the four groups.The relationship between abdominal muscle composition and AAC was assessed using Spearman rank correlation analysis and partial correlation analysis.Results AACs were positively correlated with age,male,dialysis age,diabetes,hypertension,and abdominal muscle fat area(r=0.555,0.172,0.192,0.348,0.335,0.358,all P<0.05),while no significant correlation was found with abdominal muscle area.A partial correlation analysis controlling for age,sex,dialysis age,hypertension and diabetes showed that AACs were still positively correlated with abdominal muscle fat area(r=0.183,P=0.012).Conclusion Abdominal muscle fat area in maintenance dialysis patients is positively associ-ated with the degree of AAC,and high abdominal muscle fat area is a risk factor for AAC.Enhanced muscle exercise may prevent the risk of vascular calcification in dialysis patients.

关 键 词：定量CT 维持性透析 腹主动脉钙化 肌肉 肌少症 

分 类 号：R814.42[医药卫生—影像医学与核医学] R543.5[医药卫生—放射医学] R685[医药卫生—临床医学]