超声联合SARC-F评分预测肌少症的价值  

Value of ultrasound plus SARC-F scale in predicting sarcopenia

作　　者：陈莎莎 周慧琳 刘旭艳 陈逸萱 危安[1] CHEN Shasha;ZHOU Huilin;LIU Xuyan;CHEN Yixuan;WEI An(Department of Ultrasound,Hunan Provincial People′s Hospital,Changsha 410007,Hunan,China)

机构地区：[1]湖南省人民医院湖南师范大学第一附属医院超声科,湖南长沙410007

出　　处：《皖南医学院学报》2025年第1期46-50,共5页Journal of Wannan Medical College

基　　金：湖南省自然科学基金项目(2021JJ70020);湖南省科技创新计划项目(2021SK50924)。

摘　　要：目的:探索超声联合肌少症简易五项评分(SARC-F)对老年肌少症诊断及预测肌少症发生的应用价值。方法:选取2021年10月1日~2022年6月30日湖南省人民医院老年科及内分泌科年龄≥60岁住院患者167例为研究对象,分为肌少症组(69例)与非肌少症组(98例)。收集两组患者一般资料、实验室数据,测量骨骼肌质量指数(SMI),双侧前臂肌群、股内侧肌及腓肠肌最大厚度,小腿肌群最大横截面积等,探索预测肌少症发生的独立危险因素,评估小腿肌群最大横截面积联合SARC-F用于诊断及预测肌少症发生的效能。结果:167例住院患者肌少症患病率41.31%,肌少症组年龄、BMI及肌少症五条目联合小腿围量表(SARC-CalF)评分均高于非肌少症组(P<0.05),前臂肌群最大厚度、腓肠肌内侧头最大厚度、腓肠肌外侧头最大厚度、小腿肌群最大横截面积均低于非肌少症组(P<0.05),年龄、前臂肌群最大厚度、腓肠肌内侧最大厚度及小腿肌群最大横截面积、白蛋白是预测肌少症发生的独立危险因素;超声测量小腿肌群最大横截面积结合SARC-F评分相较于单独使用SARC-CalF评分,预测肌少症的特异度更高(93.88%vs.34.69%,P<0.01),Youden指数更大(0.577 vs.0.289),联合指标与SARC-CalF评分ROC曲线差值为0.145(Z=3.179,P=0.002)。结论:超声联合SARC-F对肌少症的诊断及预测具有较高的应用价值,小腿肌群最大横截面积联合SARC-F评分相较传统SARC-CalF评分,预测肌少症的效能更好。Objective:To investigate the value of ultrasound plus SARC-F scale in diagnosing sarcopenia and predicting the occurrence of sarcopenia in elderly people.Methods:167 inpatients≥60 years old were included from the Geriatric and Endocrinology Departments of our hospital from October 1,2021 to June 30,2022,and divided into sarcopenia group(n=69)and non-sarcopenia group(n=98).General information,laboratory data,skeletal muscle mass,maximum thickness of bilateral forearm muscles,vastus medialis and gastrocnemius muscles,and maximum cross-sectional area of calf muscles were collected to observe the independent risk factors for predicting the incidence of sarcopenia,and evaluate the efficacy of ultrasound plus SARC-F scale in diagnose of sarcopenia and predicting the incidence of sarcopenia.Results:The prevalence of sarcopenia among the 167 inpatients was 41.31%.The age,BMI index and SARC-CalF score of sarcopenia group were higher than those of non-sarcopenia group(P<0.05).The thickness of forearm muscles,and medial and lateral heads of gastrocnemius muscles as well as the cross-sectional area of calf muscles were lower than those of non-sarcopenia group(P<0.05).Age,forearm muscle thickness,medial gastrocnemius thickness,cross-sectional area of calf muscles,and albumin were independent risk factors for predicting the incidence of sarcopenia.Compared with the use of SARC-CalF score alone,the combination of ultrasonic measurement of the cross-sectional area of calf muscles and SARC-F score had higher specificity(93.88%vs.34.69%,P<0.01)and a larger Youden index(0.577 vs.0.289)in predicting the incidence of sarcopenia.The difference in the ROC curve between the combined index and the SARC-CalF score was 0.145(Z=3.179,P=0.002).Conclusion:Ultrasound plus SARC-F scale has high application value in the diagnosis and prediction of sarcopenia,and the maximum cross-sectional area of calf muscles combined with SARC-F score has better efficiency in predicting the incidence of sarcopenia than the traditional SARC-CalF score.

关 键 词：肌少症 超声 危险因素 小腿肌群横截面积 肌少症简易五项评分 

分 类 号：R685[医药卫生—骨科学] R445.1[医药卫生—外科学]