基于胸部CT分析基线骨骼肌含量对ICU患者预后的影响

目的 探讨危重患者入ICU时基线骨骼肌含量与病情危重程度及预后的相关性。方法 纳入在ICU治疗时间≥48 h的危重患者79例,测量其入ICU时胸部CT第七胸椎（T7）水平横断面胸肌面积（PMA）,分析PMA与90 d病死率、90 d内生存率、28 d内非ICU生存日数、28 d内无机械通气生存日数、ICU病死率、院内病死率等指标的相关性。结果 在校正性别、危重症营养风险评分、 Charlson共病指数、血红蛋白等因素后,基线PMA较大患者90 d病死率更低,90 d内生存率更高,28 d内非ICU生存日数更多,院内病死率也更低,与基线PMA较小患者比较差异均具有统计学意义（P均< 0.05）。结论 危重患者入ICU时的基线骨骼肌含量可用于预测病情严重程度、需要体外生命支持和ICU治疗的时间和临床预后。

Correlation between baseline skeletal muscle mass and prognosis of patients in comprehensive ICU based on chest CT scan

Objective To investigate the correlation between the baseline skeletal muscle mass and the severity and prognosis of critical patients in ICU. Methods Seventy-nine patients admitted to ICU for≥48 h were recruited in this study. The （T7） level cross-sectional pectoral muscle area （PMA） upon admission to ICU was measured. The correlation between PMA and 90 d mortality, survival rate to 90 d, ICU-free survival to 28 d, ventilator-free survival to 28 d, ICU mortality and hospital mortality was analyzed. Results After the adjustment of gender, NUTRIC score, Charlson comorbidity index （CCI） and hemoglobin, patients with larger baseline PMA still obtained significantly lower 90 d mortality, higher survival rate to 90 d and ICU-free survival to 28 d, and lower hospital mortality compared with their counterparts with smaller baseline PMA （all P < 0.05）. Conclusions Upon admission to ICU, baseline skeletal muscle mass of critical patients can be utilized to predict the severity of illness, the duration of ventilator use, the length of ICU stay and clinical prognosis of patients.