中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (04): 273-277.doi: 10.3969/j.issn.1671-4091.2025.04.003

• 临床研究 • 上一篇    下一篇

影响维持性血液透析患者肌肉衰减综合征的危险因素

杨 群   戴莉敏   施 杨   徐 骏   

  1. 212001 镇江，1江苏大学医学院
    212000 镇江，2江苏大学附属人民医院内分泌科
    225003 扬州，3江苏省扬州五台山医院神经内科
    225001 扬州，4江苏省苏北人民医院血液净化中心
  • 收稿日期:2024-10-21 修回日期:2025-01-15 出版日期:2025-04-12 发布日期:2025-04-12
  • 通讯作者: 戴莉敏 E-mail:dailm11@126.com
  • 基金资助:
    江苏省卫生健康委科研项目(H2023111)

Analysis of risk factors for muscle decay syndrome in maintenance hemodialysis patients

YANG Qun, DAI Li-min, SHI Yang, XU Jun   

  1. iangsu University School of Medicine, 212001 Zhenjiang, China; 2Department of Endocrinology, Jiangsu University Affiliated People's Hospital, 212000 Zhenjiang, China; 3Department of Neurology, Mount Wutai Hospital, Yangzhou, Jiangsu Province, 225003 Yangzhou, China; 4Blood Purification Center of Subei People's Hospital, Yangzhou 225001, China
  • Received:2024-10-21 Revised:2025-01-15 Online:2025-04-12 Published:2025-04-12
  • Contact: 212000 镇江，2江苏大学附属人民医院内分泌科 E-mail:dailm11@126.com

摘要： 目的 基于LASSO回归模型分析影响维持性血液透析(maintenance hemodialysis，MHD)患者肌肉衰减综合征(muscle wasting syndrome，MWS)发生的高危因素。 方法 选取江苏省苏北人民医院收治的MHD患者，参照亚洲肌肉衰减综合征诊断标准分为肌肉正常组及肌肉衰减组，比较2组患者基线资料。通过LASSO回归分析影响MHD患者MWS发生的危险因素，ROC曲线验证预测模型的准确度。 结果 共纳入280例患者，其中肌肉正常组152例，肌肉衰减组128例。LASSO回归分析显示年龄(OR=1.164，95% CI：1.043～1.299，P=0.007)、透析后体质量(OR=0.749，95% CI：0.610～0.920，P=0.006)、上臂围(OR=1.802，95% CI：1.299～2.500，P＜0.001)、腿围(OR=2.787，95% CI：1.463～5.311，P=0.002)、肌肉量(OR=0.680，95% CI：0.532～0.868，P =0.002)、肌酐(OR=0.456，95% CI：0.232～0.897，P=0.023)、尿素氮(OR=0.162，95% CI：0.070～0.373，P＜0.001)是MHD患者MWS的危险因素。ROC曲线验证LASSO回归结果的AUC为0.713(95% CI：0.654～0.773)，敏感度为76.60%，特异度为64.60%，Youden指数J=0.412。 结论 LASSO-Logistic回归模型可预测MHD患者MWS发生的高危因素且具有良好的预测效能，为临床干预和治疗提供了重要参考。

关键词: LASSO回归分析, 维持性血液透析, 肌肉衰减综合征

Abstract: Objective  To analyze the risk factors of Muscle Wasting Syndrome (MWS) in Maintenance Hemodialysis (MHD) patients based on LASSO regression model.  Methods   Subei People's Hospital, Jiangsu Province of 280 MHD patients were selected and divided into normal muscle group and sarcopenia group according to the Asian sarcopenia comprehensive diagnostic criteria. The baseline data of the two groups were compared, and the risk factors of MWS in MHD patients were analyzed by LASSO regression. The Receiver Operating Characteristic (ROC) curve was used to verify the accuracy of the prediction model.  Results  There were 152 patients in the normal muscle group and 128 patients in the sarcopenia group. LASSO regression analysis showed that age (OR 1.164, 95% CI:1.043～1.299, P=0.007), weight after dialysis (OR 0.749, 95% CI:0.610～0.920, P=0.006), upper arm circumference (OR 1.802, 95% CI:1.299～2.500, P＜0.001), leg circumference (OR 2.787, 95% CI:1.463～5.311, P=0.002), muscle mass (OR 0.680, 95% CI:0.532～0.868, P＜0.001), and muscle mass (OR 0.680, 95% CI:0.532～0.868, P=0.002), creatinine (OR 0.456, 95% CI:0.232～0.897, P=0.023) and urea nitrogen (OR 0.162, 95% CI:0.070～0.373, P＜0.001) were risk factors for MWS in MHD patients. ROC Curve showed that the Area Under Curve (AUC) of LASSO regression was 0.713 (95% CI: 0.654～0.773), the sensitivity was 76.60%, the specificity was 64.60%, and the Youden index J=0.412. Conclusions  The LASAS-Logistic regression model can predict the high-risk factors of MWS in MHD 

Key words: LASSO regression analysis, Maintenance hemodialysis, Muscle wasting syndrome

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