摘要
目的肝硬化患者在疾病进展过程中出现肌肉减少症对临床预后及其他并发症发生的影响尚不完全清楚。本研究的目的是探讨肝硬化患者肌肉减少症发生情况及其影响因素。方法2019年3月~2021年2月我院收治的肝硬化患者311例,使用CT扫描仪进行腹部CT扫描,导出第三腰椎(L3)水平横向CT图像,应用SliceOmatic V5.0图像分析软件识别L3水平肌肉状况。采用多因素Logistic回归分析肝硬化患者发生肌肉减少症的危险因素。结果本组住院的肝硬化患者肌肉减少症发生率为11.6%(36/311);肌肉减少症组年龄、男性比例和自发性细菌性腹膜炎(SBP)发生率分别为(57.8±13.6)岁、88.9%和22.2%,与未发生肌肉减少症组【分别为(50.0±11.1)岁、58.2%和9.3%,P<0.05】比,差异显著;肌肉减少症组体质指数、外周血白细胞计数、血红蛋白、白蛋白和高密度脂蛋白水平分别为19.6(2.4)kg/m^(2)、4.5(3.4)×10^(9)/L、100.5(36.5)g/L、31.8±6.6 g/L和0.9(0.4)mmol/L,与未发生肌肉减少症组【分别为22.5(4.2)kg/m^(2)、3.5(2.6)×10^(9)/L、129.0(40.3)g/L、36.3±6.6g/L和1.0(0.4)mmol/L,P<0.05】比,差异显著;经多因素Logistic回归分析发现,年龄、性别、WBC、Hb、ALB和BMI可以显著影响肝硬化患者肌肉减少症的发生(P值均<0.05)。更进一步分析发现,随着年龄和WBC增高或男性、Hb、ALB和BMI降低,肝硬化患者出现肌肉减少症的可能性就越高。结论肝硬化患者可并发肌肉减少症,一些临床指标和化验检查结果可以提示肌肉减少症的存在,这些患者可能更容易并发SBP,需要引起临床医生的重视。
Objective The impact of sarcopenia in patients with liver cirrhosis on the clinical prognosis and other comorbidities is not fully understood.The objective of this study was to investigate the occurrence and influencing factors of sarcopenia in patients with cirrhosis,and its impact on the occurrence of spontaneous bacterial peritonitis(SBP).Methods All inpatients with cirrhosis were included in our hospital between March 2019 and February 2021,and all patients underwent CT scan for muscle evaluation at L3 lumbar vertebra level by SliceOmatic V5.0 software.The multivariate Logistic regression analysis was applied to analyze the impacting factors for sarcopenia.Results A total of 311 patients with cirrhosis were included in this study,with the sarcopenia incidence of 11.6%(36/311);the age,male proportion and the incidence of SBP in patients with sarcopenia were(57.8±13.6)yr,88.9%and 22.2%,significantly different compared to[(50.0±11.1)yr,58.2%and 9.3%,respectively,P<0.05]in those without sarcopenia;the body mass index(BMI),white blood cell(WBC)counts,hemoglobulin(Hb),albumin and high-density lipoprotein levels in patients with sarcopenia 19.6(2.4)kg/m^(2),4.5(3.4)×10^(9)/L,100.5(36.5)g/L,31.8±6.6 g/L and 0.9(0.4)mmol/L,significantly different compared to[22.5(4.2)kg/m^(2),3.5(2.6)×10^(9)/L,129.0(40.3)g/L,36.3±6.6g/L and 1.0(0.4)mmol/L,respectively,P<0.05]in patients without sarcopenia;the multivariate Logistic regression analysis showed that the age,gender,WBC,Hb,albumin and BMI were all the independent risk factors for the existence of carcopenia(all P<0.05).Conclusion The patients with liver cirrhosis could have sarcopenia,which might be a precipitating factor for the occurrence of SBP.
作者
邱婉春
毛小荣
邓乐风
龚燕华
孙雪
李俊峰
Qiu Wanchun;Mao Xiaorong;Deng Lefeng(First Clinical Medical College,Lanzhou University,Lanzhou 730000,Gansu Province,China)
出处
《实用肝脏病杂志》
CAS
2023年第5期674-677,共4页
Journal of Practical Hepatology
基金
甘肃省自然科学基金资助项目(编号:20JR5RA364)
甘肃省重点研发计划项目(编号:21YF5FA121)
甘肃省感染肝病临床医学研究中心科研项目(编号:21JR7RA392)
兰州大学第一医院院长基金资助项目(编号:ldyyyn2020-02/ldyyyn2020-14)
兰州大学第一临床医学院卓越研究计划项目(编号:20210060105)。
作者简介
第一作者:邱婉春,女,26岁,硕士研究生。主要从事肝病诊断与治疗学研究。E-mail:qiuwchun@163.com;共同第一作者:毛小荣,女,博士生研究生导师,兰州大学第一医院感染科主任。主要从事传染病的诊断和治疗学研究。E-mail:mxr2013@126.com;通讯作者:李俊峰,E-mail:junfenglee@126.com。
