终末期肾脏病行维持性血液透析患者发生肌少症的相关影响因素分析  

Analysis of related influencing factors of sarcopenia in end-stage renal disease patients undergoing maintenance hemodialysis

作　　者：陈萱[1] 陈敏[1] 赵金文[1] 周敏 王国乙 Chen Xuan;Chen Min;Zhao Jinwen;Zhou Min;Wang Guoyi(Department of Nephrology,the First Huai'an Hospital Affiliated to Nanjing Medical University,Huai'an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院肾内科,淮安223300

出　　处：《国际泌尿系统杂志》2024年第3期385-389,共5页International Journal of Urology and Nephrology

基　　金：2021年度江苏省卫健委科研项目(JSWJ2021B009)。

摘　　要：目的:探讨肌少症在行维持性血液透析(MHD)的终末期肾脏病(ESRD)患者中的发生情况,总结其影响因素。方法:回顾性分析2018年1月至2022年12月于本院血液净化中心收治的250例行规律MHD的ESRD患者的临床资料,根据是否发生肌少症分为合并肌少症组(120例)与未合并肌少症组(130例)。比较两组患者的人体测量学指标、改良定量综合营养评估量表(MQSGA)等差异,采用多因素logistic回归分析ESRD患者发生肌少症的影响因素。结果:合并肌少症组的握力、体质量指数(BMI)、四肢骨骼肌量指数、4 m步行速度、前白蛋白、白蛋白、体蛋白质含量低于未合并肌少症组;年龄、β2微球蛋白、MQSGA评分、C反应蛋白(CRP)高于未合并肌少症组,差异均有统计学意义(均P<0.05);多因素logistic回归分析结果显示,年龄、握力、体蛋白质含量、BMI、MQSGA评分、CRP是ESRD行MHD患者发生肌少症的影响因素(均P<0.05)。结论:ESRD行MHD患者发生肌少症与年龄、握力、体蛋白质含量、BMI、MQSGA评分、CRP水平等独立相关,应予以高度重视。Objective To analyze the occurrence of sarcopenia in end-stage renal disease(ESRD)patients undergoing maintenance hemodialysis(MHD)and summarize its influencing factors.Methods Retrospective analysis of 250 ESRD patients with regular MHD admitted to the Blood Purification Center of Huai'an First Hospital Affiliated to Nanjing Medical University from January 2018 to December 2022 as the study subjects.Based on the occurrence of sarcopenia,the patients were divided into a group with concomitant sarcopenia(120 cases)and a group without concomitant sarcopenia(130 cases).The differences of anthropometric indicators and Modified Quantitative Subjective Global Assessment(MQSGA)were compared,and the influencing factors of sarcopenia were analyzed by multiple logistic regression.Results The grip strength,body mass index(BMI),limb skeletal muscle mass index,4 m walking speed,prealbumin,albumin,and body protein content of the group with sarcopenia were lower than those of the group without sarcopenia.The levels of age,β2-microglobulin,MQSGA score,and C-reactive protein(CRP)of the group with concomitant sarcopenia were higher than those in the group without sarcopenia(all P<0.05).Multivariate logistic regression analysis showed that age,grip strength,body protein BMI,MQSGA score,CRP were closely related to the occurrence of sarcopenia in ESRD with MHD(all P<0.05).Conclusions ESRD patients with MHD have sarcopenia that is independently related to age,grip strength,body protein content,BMI,MQSGA score,CRP level,etc.,and should be highly valued.

关 键 词：肾透析 终末期肾脏疾病 肌少症 

分 类 号：R692.5[医药卫生—泌尿科学]