摘要
目的:探讨维持性血液透析(MHD)患者肌少症的影响因素及其与预后关系。方法:选取MHD患者270例作为研究对象,根据亚洲肌少症工作组制定的诊断标准,通过测量握力、步速及生物电阻抗法评估四肢骨骼肌质量指数(ASMI),分析肌少症的发生率并通过多因素Logistic回归分析其影响因素。随访12个月观察患者预后情况,包括跌倒、再住院和全因死亡等。结果:270例MHD患者中有肌少症患者107例,发生率为39.63%。根据有无肌少症分为肌少症组(n=107)和非肌少症组(n=163)。肌少症组患者年龄大于非肌少症,肌少症组舒张压、步速、握力和ASMI均低于非肌少症组,两组糖尿病和高血压患病率差异无统计学意义(P>0.05)。肌少症组的C反应蛋白(CRP)、铁蛋白和转铁蛋白饱和度高于非肌少症组,而血肌酐、尿素氮、白蛋白、总铁结合力水平低于非肌少症组(P<0.05)。多因素Logistic回归分析表明,CRP升高、增龄和总铁结合力降低是MHD患者肌少症的危险因素。随访12个月期间肌少症组跌倒发生率和再住院率(16.82%和54.21%)均高于非肌少症组(8.59%和31.90%)(P<0.05)。结论:MHD肌少症发生率高,炎症、增龄和总铁结合力是肌少症的影响因素。
Objective:To explore the incidence of sarcopenia and related risk factors of sarcopenia in maintenance hemodialysis(MHD)patients.and analyze its relationship with the prognosis.Methods:A total of 270 stable MHD patients were enrolled in the study.According to the diagnostic criteria established by the Asia Working Group for Sarcopenia(2019 Consensus Update on Sarcopenia Diagnosis and Treatment),the incidence of sarcopenia in patients was examined by measuring handgrip strength,walking speed and skeletal muscle mass of the limbs using bioelectrical impedance analysis.A multivariate Logistic regression analysis was performed on the influencing factors of sarcopenia.All patients were followed up for 12 months to observe the prognosis including fall,hospitalization and death from any cause.Results:Among 270 hemodialysis patients,the incidence of sarcopenia was 39.63%(107 cases).The age in sarcopenia group were bigger than these in the non-sarcopenia group.Diastolic blood pressure,gait speed,handgrip strength and appendicular skeletal muscle mass index in sarcopenia group were lesser than these in the non-sarcopenia group(P<0.05),and there was no statistically significant difference in the prevalence of diabetes mellitus and hypertension between the two groups(P>0.05).Serum creatinine,blood urea nitrogen,albumin and total iron binding capacity were lesser and C-reactive protein(CRP),serum ferritin and transferring saturation were higher in the sarcopenia group than these in the non-sarcopenia group(P<0.05).Multivariate logistic regression analysis showed that CRP,Age and total iron binding capacity were independent risk factors for sarcopenia.The incidence of fall ang readmission rate(16.82%and 54.21%)in the sarcopenia group during follow-up were higher than those(8.59%and 31.90%)in the non-sarcopenia group(P<0.05).Conclusion:MHD patients experience a relatively high incidence rate of sarcopenia.Age,inflammation and total iron binding capacity are the influencing factors of Sarcopenia in MHD patients.
作者
姜璐
何萍
王维平
JIANG Lu;HE Ping;WANG Weiping(Department of Nephrology,Jiangdu People’s Hospital of Yangzhou,the Affiliated Hospital of Yangzhou University,Yangzhou,225200)
出处
《中国中西医结合肾病杂志》
2024年第3期206-210,共5页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
扬州市江都人民医院院内科研基金资助项目(No.YNKT202006)。
关键词
肌少症
血液透析
危险因素
预后
Sarcopenia
Maintenance hemodialysis
Risk factors
Prognosis
