维持性血液透析患者肌肉衰减综合征现状及影响因素分析

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目的:探讨维持性血液透析(MHD)患者肌肉衰减综合征的发生情况并分析其影响因素。方法:选取规律透析且病情稳定的441例非住院的MHD患者,使用多频生物电阻抗法测量患者的四肢骨骼肌质量,使用握力计测量握力评估患者的肌肉力量,测试4 m步速评估患者的活动能力,并收集相关资料,采用Logistic回归分析影响因素。结果:441例MHD患者中肌肉衰减综合征的发生率是16.55%(73/441),年龄>60岁的发生率为28.91%(61/211)。二元Logistic回归分析显示,年龄(n OR=0.213,95%n CI 0.099~0.458,n P<0.01)、Karnofsky活动指数(n OR=9.661,95%n CI 3.850~24.244,n P<0.01)、主观全面营养评估(n OR=0.491,95%n CI 0.250~0.965,n P=0.039)、血磷(n OR=0.422,95%n CI 0.204~0.875,n P=0.020)、体质量指数(n OR=0.754,95%n CI 0.609~0.935,n P=0.010)为MHD患者肌肉衰减综合征的主要影响因素。n 结论:年龄较大、体力活动减少、营养不良的MHD患者肌肉衰减综合征发生率较高,临床对于这类患者应早期采取干预措施,降低肌肉衰减综合征的发生。“,”Objective:To investigate the incidence of sarcopenia in maintenance hemodialysis (MHD) patients and analyze its influencing factors.Methods:Totally 441 non-hospitalized MHD patients in stable condition were selected,by bioelectrical impedance analysis (BIA) to test appendicular skeletal muscle mass(ASM), by testing grip strength of MHD patients, to assess Muscle strength, by gait speed test to measure the 4-m usual walking speed, to assess physical performance of MHD patients.Risk factors of sarcopenia were identified by Logistic regression analysis.Results:The total incidence of sarcopenia in 441 MHD patients was 16.55% (73/441) and the incidence of sarcopenia in patients over 60 years old was 28.91% (61/211).The results showed older age (n OR=0.213, 95%n CI 0.099-0.458, n P<0.01), Karnofsky (n OR=9.661, 95%n CI 3.850-24.244, n P<0.01), subjective global assessment (n OR=0.491, 95%n CI 0.250-0.965, n P=0.039), serum phosphorus (n OR=0.422, 95%n CI 0.204-0.875, n P=0.020) and body mass index (n OR=0.754, 95%n CI 0.609-0.935, n P=0.010) were risk factors of sacopenia.n Conclusions:The incidence of sarcopenia in elder, performed less physical activity, malnutrition predisposed MHD patients was high, so to those patients we should be paid more attention and gave active interventions to reduce sarcopenia.
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