联合肌肉减少症建立模型预测结直肠癌术后腹腔内感染风险

目的：分析直肠癌术后腹腔内感染与肌肉减少症之间的关系,并构建联合模型预测腹腔内感染风险。方法：收集383例接受结直肠癌根治术的患者,在手术前收集并测量诊断肌肉减少症的三要素,包括腰椎骨骼肌指数、术前握力和步行速度。通过单因素和多因素分析确定影响腹腔内感染的因素。构建由独立风险因素组成的联合预测模型,以量化结直肠癌术后腹腔内感染的个体风险。结果：383例患者中,有93例被诊断出肌肉减少症,而44例被诊断出腹腔内感染。Logistic分析表明,肌肉减少症、肿瘤大小、年龄是 结直肠癌术后腹腔内感染的独立预后因素（P ＜0.05）。腹腔内感染的联合预测模型能够可靠地预测及量化结直肠癌术后发生腹腔内感染的风险（一致性指数为0.710）。结论：术前肌肉减少症是结直肠癌术后发生腹腔内感染的的独立预测因子。本联合预测模型是一种简单实用的工具,可量化腹腔内感染的个体风险,用于识别高风险患者。     

Sarcopenia,calf circumference,and physical function of elderly women: a cross-sectional study

OBJECTIVES: To determine whether calf circumference (CC), related to appendicular skeletal muscle mass, can be used as a measure of sarcopenia and is related to physical function. DESIGN: Retrospective analysis of data from 1992 to 1994 of the European Patient Information and Documentation Systems Study. SETTING: Community setting in France. PARTICIPANTS: One thousand four hundred fifty-eight French women aged 70 and older without previous history of hip fracture were recruited from the electoral lists. MEASUREMENTS: Muscular mass was assessed using dual-energy x-ray absorptiometry (DEXA). CC was measured using a tape measure. Anthropometric measurements (height; weight; and waist, hip, and calf circumference), strength markers (grip strength), and self-reported physical function were also determined. Sarcopenia was defined (using DEXA) as appendicular skeletal muscle mass (weight (kg)/height (m2)) less than two standard deviations below the mean of a young female reference group. RESULTS: The prevalence of sarcopenia was 9.5%. CC was correlated with appendicular skeletal muscle mass (r = 0.63). CC under 31 cm was the best clinical indicator of sarcopenia (sensitivity = 44.3%, specificity = 91.4%). CC under 31 cm was associated with disability and self-reported physical function but not sarcopenia (defined using DEXA), independent of age, comorbidity, obesity, income, health behavior, and visual impairment. CONCLUSION: CC cannot be used to predict sarcopenia defined using DEXA but provides valuable information on muscle-related disability and physical function.