维持性血液透析病人骨骼肌减少症发生率和危险因素研究

目的:研究骨骼肌减少症在维持性血液透析(MHD)病人中的发生率和影响因素。方法:选取规律血液透析且病情稳定的131例非住院MHD病人,采用生物电阻抗法(BIA)测定病人的肌肉质量,并计算骨骼肌质量指数,测定病人的握力,用改良量化主观整体评估(MQSGA)法评估病人的营养状况,同时检测相关实验室指标,采用Logstic回归分析MHD病人肌少症的相关危险因素。结果:在131例MHD病人中,肌少症的发生率为41.22%(54/131),有或无肌少症两组间性别、透析时间、超敏C反应蛋白(hs-CRP)、MQSGA得分差异有显著性统计学意义(P0.05)。Logstic回归分析显示,男性肌少症发生率是女性的43.67倍,随着hs-CRP水平升高和MQSGA得分增加,肌少症的发生风险明显增加,差异有显著性统计学意义(P0.05)。结论:MHD病人肌少症的发生率高,男性、微炎症状态和营养不良是发生肌少症的危险因素。

The incidence and risk factors associated with sarcopenia in maintenance hemodialysis patients

Objective:To investigate the incidence and related factors with sarcopenia in maintenance hemodialysis patients.Methods:A total of 131 patients with non-hospitalized maintenance hemodialysis who had been maintained for at least 3 months and in a stable condition were enrolled in a cross-sectional study.Bioelectric impedance analysis (BIA) method was employed to examine the muscle mass.MQSGA questionnaire was used to evaluate patients'nutrition status as well as related laboratory indicators.Logistic regression was used to analyze the risk factors of sarcopenia in MHD patients.Results:The incidence of sarcopenia in 131 MHD patients was 41.22％ (54/131).Significant differences were observed in gender,duration of hemodialysis,hs-CRP and the score of M(Q)SGA between the two groups.The incidence of sarcopenia in male was 43.67 times compared with female.And with the increase of hs-CRP levels and MQSGA score,the incidence of sarcopenia was increased as well (P ＜0.05).Conclusion:Sarcopenia has a high incidence in MHD patients,and male,micro-inflammatory state and malnutrition were the risk factors.