中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (04): 273-277.doi: 10.3969/j.issn.1671-4091.2023.04.006

• 临床研究 • 上一篇    下一篇

5种肌少症筛查工具在维持性血液透析患者中的应用效果比较

王凯选   孙 艳   崔 超   王思义   石新茹   刘志梅   

  1. 266021 青岛，青岛市市立医院1护理部 2血液净化中心 
    266071 青岛，3青岛大学护理学院
  • 收稿日期:2022-09-29 修回日期:2023-01-20 出版日期:2023-04-12 发布日期:2023-04-12
  • 通讯作者: 刘志梅 E-mail:qdsllzm1968@126.com
  • 基金资助:
    青岛市2020年度医药科研指导计划(2020-WJZD011)

Effectiveness comparison of the five screening tools for sarcopenia in maintenance hemodialysis patients 

WANG Kai-xuan, SUN Yan, CUI Chao, WANG Si-yi, SHI Xin-ru, LIU Zhi-mei   

  1. Department of Nursing and 2Blood Purification Center, Qingdao Municipal Hospital, Qingdao 266021, China; 3School of Nursing, Qingdao University, Qingdao 266071, China
  • Received:2022-09-29 Revised:2023-01-20 Online:2023-04-12 Published:2023-04-12
  • Contact: 266021 青岛，青岛市市立医院1护理部 E-mail:qdsllzm1968@126.com

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摘要： 目的 比较5种肌少症筛查工具在维持性血液透析(maintenance hemodialysis，MHD)患者中的应用效果。 方法  便利选取2020年10月～2021年4月在青岛市市立医院血液净化中心接受MHD治疗的340例患者，应用肌少症5条目即力量、步行辅助、从椅子上起身、爬楼梯、跌倒(strength,assistence in walking, rise from a chair,climb stairs and falls，SARC-F)问卷、SARC-F结合小腿围(SARC-F combined with calf circumference，SARC-CalF)问卷、SARC-F结合老龄和体质量指数(SARC-F adding elderly and body mass index information，SARC-F+EBM)问卷、迷你肌少症风险评估-7条目(mini sarcopenia risk assessment-7 items，MSRA-7)问卷及迷你肌少症风险评估-5条目(mini sarcopenia risk assessment-5 items，MSRA-5)问卷进行筛查。采用SPSS 22.0和MedCalc 19.6软件绘制受试者工作特征曲线，并计算曲线下面积(AUC)；根据约登指数确定各筛查工具的最佳临界值，并计算各工具在原始和最佳临界值时的筛查性能指标。 结果  有84例(24.71%)患者诊断为肌少症。5种筛查工具对MHD患者肌少症筛查的AUC为0.759～0.872，SARC-CalF问卷的AUC分别高于SARC-F问卷   (Z=2.506，P=0.012)、SARC-F+EBM问卷(Z =3.451，P=0.001)、MSRA-7问卷(Z=2.841，P=0.005)及MSRA-5问卷(Z=2.248，P=0.025)，且其灵敏度(78.57%)、特异度(89.84%)等指标均较高，对应的最佳临界值为11分。 结论  SARC-CalF问卷的筛查准确性最高，且在最佳临界值时具有较高的灵敏度和特异度，更适合用于MHD患者肌少症的早期风险筛查。

关键词: 维持性血液透析, 肌肉减少症, 筛查, 诊断性试验

Abstract: Objective To compare the application effect of five screening tools for sarcopenia in maintenance hemodialysis (MHD) patients. Methods A survey was conducted in 340 patients who received MHD treatment in blood purification centre of Qingdao municipal hospital by convenience sampling from October 2020 to April 2021. Strength, assistance with walking, rise from a chair, climb stairs and falls (SARC-F) questionnaire, SARC-F combined with calf circumference (SARC-CalF) questionnaire, SARC-F adding elderly and body mass index information (SARC-F+EBM) questionnaire, mini sarcopenia risk assessment-7 items (MSRA-7) questionnaire, mini sarcopenia risk assessment-5 items (MSRA-5) questionnaire were used for screening. Receiver operating characteristic curve was drawn and the area under the curve (AUC) was calculated using SPSS 22.0 and MedCalc 19.6 software. The optimal cut-off value of five screening tools were determined according to the Yoden index. The performance indicators of five screening tools at the original cut-off value and the optimal cut-off value were calculated respectively. Results Eighty-four (24.71%) MHD patients were diagnosed as sarcopenia. AUC of five screening tools in MHD patients ranged from 0.759 to 0.872. The AUC of SARC-CalF questionnaire was larger than that of SARC-F questionnaire (Z2.506, P0.012), SARC-F+EBM questionnaire (Z3.451, P0.001), MSRA-7 questionnaire (Z2.841, P0.005), MSRA-5 questionnaire (Z2.248, P0.025). Furthermore, its sensitivity (78.57%) and specificity (89.84%) were high with the optimal cut-off value being 11 points. Conclusion SARC-CalF questionnaire has the highest accuracy of all screening tools and has high sensitivity and specificity at the optimal cut-off value, so it is more suitable for being used to screening the risk of sarcopenia in MHD patients than the other four screening tools.

Key words: Maintenance hemodialysis, Sarcopenia, Screening, Diagnostic test

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