肝硬化患者肌少症发生现状及危险因素分析  

Analyze the current situation and risk factors of sarcopenia in patients with liver cirrhosis and develop countermeasures

作　　者：王晶晶 申丽香[1] 赵聪 WANG Jing-jing;SHEN Li-xiang;ZHAO Cong(Department of Gastroenterology,Henan Provincial Peoples Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院消化内科,郑州450003

出　　处：《医药论坛杂志》2024年第24期2589-2593,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190610)。

摘　　要：目的 分析肝硬化患者肌少症发生现状及危险因素并依此制定干预措施。方法选取2022年7月至2023年12月河南省人民医院收治的114例肝硬化患者临床资料。根据是否发生肌少症,将患者分为肌少症组、非肌少症组。比较两组基线资料、实验室指标;采用二元logistic回归分析检验肝硬化患者发生肌少症的影响因素;根据二元logistic回归分析结果构建列线图模型并进行内部验证。结果114例肝硬化患者中,发生肌少症46例,肌少症发生率为40.35%;肌少症组BMI、上臂围、小腿围、ALB低于非肌少症组,男性、存在腹水占比高于非肌少症组(P<0.05);经二元logistic回归分析结果显示,男性、存在腹水是肝硬化患者发生肌少症的独立危险因素(OR>1,P<0.05),BMI、ALB是保护因素(OR<1,P<0.05);基于以上影响因素构建列线图模型,使用Bootstrap内部验证法对列线图模型进行验证,C-index值0.927,绘制受试者工作特征(ROC)曲线进行内部验证,结果显示,列线图模型预测肝硬化患者发生肌少症的AUC为0.927(95%置信区间:0.877~0.978,P<0.001),具有一定预测价值;特异度、敏感度、约登指数分别0.912、0.870、0.782。结论肝硬化患者肌少症发生率较高,BMI、性别、ALB、腹水是肝硬化患者发生肌少症的影响因素,且在预测肝硬化患者发生肌少症上具有一定价值,医护人员可通过以上影响因素采取针对性措施,预防或降低肝硬化患者发生肌少症的风险。Objective To analyze the current situation and influence factor of sarcopenia in patients with liver cirrhosis,and to develop intervention measures based on this.Methods Selection of clinical data from 114 patients with liver cirrhosis admitted from July 2022 to December 2023.According to the occurrence of sarcopenia,patients were divided into sarcopenia group and non sarcopenia group.The baseline data and laboratory indicators of two groups were cpmpared;using logistic regression to analyze the influencing factors of sarcopenia in patients with liver cirrhosis;construct a column chart model based on the results of binary logistic regression analysis and conduct internal validation.Results Among 114 patients with cirrhosis,46 cases developed sarcopenia,with a sarcopenia incidence rate of 40.35%;the BMI,upper arm circumference,lower leg circumference,ALB was lower than that of the non sarcopenia group,and the proportion of males with ascites was higher than that of the non sarcopenia group(P<0.05);according to logistic regression analysis,male and ascites are influence factors for sarcopenia in patients with liver cirrhosis(OR>1,P<0.05),while BMI and ALB were protective factors(OR<1,P<0.05).Based on the above influencing factors,a column chart model was constructed and validated using the Bootstrap internal validation method.The C-index value was 0.927,and the receiver operating characteristic(ROC)curve was plotted for internal validation.The results showed that the AUC of the column chart model for predicting muscle atrophy in patients with cirrhosis was 0.927(95%confidence interval:0.877-0.978,P<0.001),which has a certain predictive value;the specificity,sensitivity,and Youden index were 0.912,0.870,and 0.782,respectively.Conclusion The incidence of sarcopenia in patients with liver cirrhosis is relatively high.BMI,gender,ALB,and ascites are risk factors for sarcopenia in patients with liver cirrhosis,and they have certain value in predicting the occurrence of sarcopenia in patients with liver cirrhosis.Medical

关 键 词：肝硬化 肌少症 发生现状 影响因素 列线图 

分 类 号：R575.2[医药卫生—消化系统]