中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (04): 295-299.doi: 10.3969/j.issn.1671-4091.2026.04.005

• 临床研究 • 上一篇    下一篇

维持性血液透析患者肌少症的风险调查及影响因素

武 阳   雷圣英   郭雨虹   

  1. 473000 南阳，南阳市中心医院1血液净化科 2院前急救科
  • 收稿日期:2025-06-23 修回日期:2026-01-30 出版日期:2026-04-12 发布日期:2026-04-12
  • 通讯作者: 武阳 E-mail:18337700366@163.com

Risk investigation and influencing factors of sarcopenia in maintenance hemodialysis patients

WU Yang， LEI Sheng-ying，GUO Yu-hong   

  1. Department of Blood Purification，and  2Department of pre-hospital Emergency, Nanyang Central Hospital，Nanyang 473000，China
  • Received:2025-06-23 Revised:2026-01-30 Online:2026-04-12 Published:2026-04-12
  • Contact: 473000 南阳，南阳市中心医院1血液净化科 E-mail:18337700366@163.com

摘要： 目的  探讨维持性血液透析(maintenance hemodialysis，MHD)患者肌少症的发生风险及其影响因素。 方法 采用横断面研究设计，观察南阳市中心医院2023年6月—2025年1月收治的MHD患者，根据是否发生肌少症分为肌少症组、非肌少症组。收集患者临床资料，通过多因素模型分析MHD患者肌少症发生的风险因素。 结果 共纳入150例患者，其中发生肌少症58例(38.67%)；与非肌少症组(n=92)相比，肌少症组年龄(t=5.339，P＜0.001)、透析龄(t=7.191，P＜0.001)、C反应蛋白(C-reactive protein，CRP)(t=13.284，P＜0.001)更高，握力(t=8.791，P＜0.001)、白蛋白(albumin，Alb)(t=6.035，P＜0.001)更低，合并糖尿病患者占比(χ2=13.581，P＜0.001)更高。单因素Logistic回归分析显示：年龄(OR=1.031，95%CI：1.009～1.053，P＜0.001)、透析龄(OR=1.422，95%CI：1.308～1.546，P＜0.001)、合并糖尿病(OR=3.219，95%CI：1.756～5.896，P＜0.001)、握力(OR=0.921，95%CI：0.904～0.939，P＜0.001)、CRP(OR=1.795，95%CI：1.662～1.940，P＜0.001)、Alb(OR=0.874，95%CI：0.836～0.914，P＜0.001)是MHD患者肌少症的危险因素。多因素Logistic回归分析显示：年龄(OR=1.368，95%CI：1.102～1.655，     P=0.001)、透析龄(OR=1.462，95%CI：1.112～1.800，P＜0.001)、合并糖尿病(OR=1.531，95%CI：1.118～1.905，P＜0.001)、握力(OR=0.846，95%CI：0.747～0.958，P=0.008)、CRP(OR=1.468，95%CI：1.105～1.785，P＜0.001)、Alb(OR=0.621，95%CI：0.475～0.812，P＜0.001)是影响MHD患者肌少症的独立危险因素。 结论 年龄、透析龄、合并糖尿病、握力、CRP、Alb均是影响MHD患者肌少症的独立危险因素，可用于早期评估患者肌少症的发生风险。

关键词: 维持性血液透析, 肌少症, 年龄, 透析龄, 糖尿病

Abstract: Objective  To explore the risk and influencing factors of sarcopenia in Maintenance Hemodialysis (MHD) patients.  Methods  A cross-sectional study was conducted. MHD patients admitted to Nanyang Central Hospital from June 2023 to January 2025 were observed and divided into a sarcopenia group and a non-sarcopenia group based on whether sarcopenia occurred. Clinical data of the patients were collected, and risk factors for sarcopenia in MHD patients were analyzed using a multivariate model.  Results  A total of 150 patients were enrolled, including 58 patients (38.67%) with sarcopenia. Compared with the non-sarcopenia group (n=92), the sarcopenia group had higher age (t=5.339, P<0.001), longer dialysis vintage (t=7.191, P<0.001), higher C-reactive protein (CRP) levels (t=13.284, P<0.001), lower grip strength (t=8.791, P<0.001), lower albumin (Alb) levels (t=6.035, P<0.001), and a higher proportion of patients with diabetes (χ²=13.581, P<0.001). Univariate logistic regression analysis showed that age (OR=1.031, 95%CI: 1.009～1.053, P<0.001), dialysis vintage (OR=1.422, 95%CI: 1.308～1.546, P<0.001), diabetes (OR=3.219, 95%CI: 1.756～5.896, P<0.001), grip strength (OR=0.921, 95%CI: 0.904～0.939, P<0.001), CRP (OR=1.795, 95%CI: 1.662～1.940, P<0.001), and Alb (OR=0.874, 95%CI: 0.836～0.914, P<0.001) were risk factors for sarcopenia in MHD patients. Multivariate logistic regression analysis revealed that age (OR=1.368, 95%CI: 1.102～1.655, P=0.001), dialysis vintage (OR=1.462, 95%CI: 1.112～1.800, P<0.001), diabetes (OR=1.531, 95%CI: 1.118～1.905, P<0.001), grip strength (OR=0.846, 95%CI: 0.747～0.958, P=0.008), CRP (OR=1.468, 95%CI: 1.105～1.785, P<0.001), and Alb (OR=0.621, 95%CI: 0.475～0.812, P<0.001) were independent risk factors for sarcopenia in MHD patients.   Conclusion  Age, dialysis vintage, diabetes, grip strength, CRP, and Alb are independent risk factors for sarcopenia in MHD patients and can be used for early assessment of the risk of sarcopenia in these patients.

Key words: Maintenance hemodialysis, Sarcopenia, Age, Dialysis vintage, Diabetes mellitus

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