5种肌少症评估量表在骨肿瘤患者中的应用研究  

Application of 5 kinds of sarcopenia assessment scales in patients with bone tumors

作　　者：余俊 陈烟雨 张琳 农源夏 陈剑 YU Jun;CHEN Yanyu;ZHANG Lin;NONG Yuanxia;CHEN Jian(Second Department of Orthopedic Surgery,Yunnan Provincial Tumor Hospital/Third Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 651118,China)

机构地区：[1]云南省肿瘤医院/昆明医科大学第三附属医院骨外二科,昆明651118

出　　处：《重庆医学》2025年第1期121-126,共6页Chongqing Medical Journal

基　　金：云南省肿瘤医院/昆明医科大学第三附属医院2023年教学联盟本科教育教学研究项目(JXYJ20230105)。

摘　　要：目的探讨5种肌少症评估量表在骨肿瘤患者肌少症筛查中的应用效果。方法采用便利抽样方法,选取2023年8月至2024年2月该院198例骨肿瘤患者作为研究对象。分别使用简易五项评分问卷(SARC-F)、改良版简易五项评分问卷(SARC-Calf)、简易五项评分结合年龄和BMI问卷(SARC-F+EBM)、迷你肌少症风险评估7条目问卷(MSRA-7)和迷你肌少症风险评估5条目问卷(MSRA-5)进行筛查,以亚洲肌少症工作组-2019(AWGS-2019)肌少症筛查标准作为诊断标准,采用受试者工作特征(ROC)曲线和曲线下面积(AUC)分析预测效能。比较各筛查工具的灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV)、Kappa值。结果根据AWGS-2019肌少症筛查标准,非肌少症组144例,肌少症组54例,肌少症发生率为27.27%。SARC-Calf和MSRA-5的灵敏度最高(81.48%);SARC-F+EBM的特异度最高(91.67%);SARC-F+EBM的PPV最高(70.00%);SARC-Calf的NPV最高(91.49%);SARC-F+EBM的AUC最高(0.890),对应的截断值为8.5分、灵敏度为83.30%、特异度为80.60%。SARC-F、MSRA-5和MSRA-7的Kappa值分别为0.206、0.336和0.324,具有一般一致性;而SARC-Calf、SARC-F+EBM的Kappa值分别为0.544和0.474,具有中等一致性。结论SARC-F+EBM可作为临床医护人员对骨肿瘤患者肌少症的最佳筛查工具。Objective To explore the application effect of five kinds of sarcopenia assessment scales in the sarcopenia screening in the patients with bone tumors.Methods The convenience sampling method was adopted to select 198 patients with bone tumor in this hospital from August 2023 to February 2024 were selected as the study subjects.The Simplified Five-Item Scoring Questionnaire(SARC-F),the Modified Simplified Five-Item Scoring Questionnaire(SARC-Calf),the Simplified Five-Item Scoring Questionnaire Combined with Age and BMI(SARC-F+EBM),the Mini Sarcopenia Risk Assessment 7-Item Questionnaire(MSRA-7)and the Mini Sarcopenia Risk Assessment 5-Item Questionnaire(MSRA-5)were used for conducting the screening.The Asian Sarcopenia Working Group-2019(AWGS-2019)screening criteria for sarcopenia were used as diagnostic criteria.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the predictive efficiency.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and Kappa value were compared among various screening tools.Results According to the AWGS-2019 screening criteria for sarcopenia,there were 144 cases in the non-sarcopenia group and 54 cases in the sarcopenia group,and the incidence rate of sarcopenia was 27.27%.SARC-Calf and MSRA-5 had the highest sensitivity(81.48%).SARC-F+EBM had the highest specificity(91.67%).SARC-F+EBM had the highest PPV(70.00%).SARC-Calf had the highest NPV(91.49%);SARC-F+EBM had the highest AUC(0.890),the corresponding cut-off value was 8.5 points,the sensitivity was 83.30%and specificity was 80.60%.The Kappa values of SARC-F,MSRA-5 and MSRA-7 were 0.206,0.336 and 0.324 respectively,possessing the ordinary consistency,while the Kappa values of SARC-Calf and SARC-F+EBM were 0.544 and 0.474 respectively,possessing the medium consistency.Conclusion SARC-F+EBM could be used as the best screening tool of clinical medical staff for sarcopenia in the patients with bone tumor.

关 键 词：肌少症 筛查工具 评估量表 骨肿瘤 

分 类 号：R685[医药卫生—骨科学]