中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (06): 441-446.doi: 10.3969/j.issn.1671-4091.2025.06.001

• 临床研究 •    下一篇

体细胞质量指数与维持性血液透析患者死亡的相关性分析

余 贤   王 梅   黄毅斌   王 垚   

  1. 214000 无锡，1无锡市锡山人民医院急诊科
    225100 扬州，2扬州大学附属医院肾内科
  • 收稿日期:2024-08-01 修回日期:2025-03-25 出版日期:2025-06-12 发布日期:2025-06-12
  • 通讯作者: 王垚 E-mail:yaowang@yzu.edu.cn

Analysis of the correlation between body cell mass index and mortality in maintenance hemodialysis patients

YU Xian, WANG Mei, HUANG Yi-bin, WANG Yao   

  • Received:2024-08-01 Revised:2025-03-25 Online:2025-06-12 Published:2025-06-12
  • Contact: 225100 扬州，2扬州大学附属医院肾内科 E-mail:yaowang@yzu.edu.cn

摘要： 目的 探讨由生物电阻抗(bioelectrical impedance analysis，BIA)获得的体细胞质量指数(body cell mass index，BCMI)与维持性血液透析(maintenance hemodialysis，MHD)患者死亡的相关性。 方法  选取2020年10月─2021年4月在锡山人民医院的MHD患者92例并随访34个月，其中死亡组27例，存活组64例。比较2组患者的临床资料差异，分析死亡预后的影响因素，分析BCMI对MHD患者死亡终点事件的预测价值。 结果 多因素COX回归模型表明BCMI(HR=0.700，95% CI：0.508～0.965，P=0.029)和前白蛋白(HR=0.993，95% CI：0.988～0.998，P=0.008)是死亡预后的独立影响因素。ROC曲线显示BCMI对MHD患者死亡预后有预测价值(AUC=0.654，P=0.020)，且BCMI最佳截断值为9.95 kg/m2。与BCMI＞9.95组相比，BCMI≤9.95组女性患者比例明显偏高(χ2=23.391，P＜0.001)，且肌少症患者占比达47.5%(χ2=14.368，P＜0.001)。生存曲线表明BCMI＞9.95组中患者生存率高于BCMI≤9.95组(Log rank P＝0.022)。 结论 低 BCMI与MHD患者的死亡预后显著相关，MHD患者低BCMI提示合并肌少症，死亡率升高，通过BIA获得MHD患者BCMI值有助于识别肌少症，判断预后，并及时干预。

关键词: 维持性血液透析, 肌少症, 体细胞质量指数, 生物电阻抗, 预后

Abstract: Objective  This study investigates the correlation between the body cell mass index (BCMI), measured using bioelectrical impedance analysis (BIA), and mortality in patients undergoing maintenance hemodialysis (MHD).  Methods  Ninety-two MHD patients from Xishan People's Hospital were selected for this study between October 2020 and April 2021 and were followed for 34 months. The cohort included 27 patients who died and 64 who survived. Clinical data were compared between thetwo groups to identify factors influencing mortality and to evaluate the predictive value of BCMI in predicting death among MHD patients. Results   Multivariate COX regression analysis identified BCMI (HR=0.700, 95% CI:0.508～0.965, P=0.029) and prealbumin (HR=0.993, 95% CI:0.988～0.998, P=0.008) as independent predictors of mortality. The receiver operating characteristic (ROC) curve indicated that BCMI has predictive value for mortality in MHD patients, with an area under the curve (AUC= 0.654, P=0.020) and an optimal cutoff value of 9.95 kg/m2. Compared with the BCMI＞9.95 group, the proportion of female patients was significantly higher in the BCMI≤9.95 group (χ2=23.391, P＜0.001), and the proportion of patients with sarcopenia was as high as 47.5% (χ2=14.368, P＜0.001). Survival curves showed that the survival rate of patients in the BCMI ＞ 9.95 group was much higher than that in the BCMI ≤ 9.95 group (log rank  P = 0.022).  Conclusion  A low BCMI is significantly associated with increased mortality in MHD patients. Low BCMI indicates comorbid sarcopenia and heightened mortality risk. BIA-measured BCMI values can aid in identifying patients with sarcopenia, enabling timely interventions to improve patient prognosis. 

Key words: Maintenance hemodialysis, Sarcopenia, Body cell mass index, Bioelectrical impedance;Prognosis

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