目的 比较肌肉减少症与传统营养评价方法 评估肝硬化患者营养状况,并进一步探讨肝硬化患者影响肌肉减少症发生的因素.方法收集2016年1月至2017年1月我科肝硬化患者资料,比较应用主观全面评价法(SGA)评分、传统营养指标及通过第3腰椎平面CT图像计算第3腰椎骨骼肌质量指数评估肝硬化患者的营养不良发生率.同时将52例肝硬化患者分为肌肉减少症组和非肌肉减少症组,分析2组间各营养指标有无差异,并进一步采用二分类Logistic回归分析法筛选影响肌肉减少症发生的危险因素.结果 52例肝硬化患者肌肉减少症的发生率为64%,2组患者年龄、性别、体质量指数(BMI)、血清白蛋白(ALB)、三头肌皮褶厚度(TSF)、上臂肌围(AMC)差异均有统计学意义(P<0.05).二分类Logistic回归分析结果示:性别[OR=0.001,95%CI(0.000,0.223),P=0.011]、BMI[OR=0.312,95%CI(0.134,0.722),P=0.007]是肌肉减少症发生的主要危险因素.结论 应用肌肉减少症可较客观地评估肝硬化患者的营养状况,且男性肝硬化患者,BMI越低,越容易发生肌肉减少症.%Objective To assess the nutritional status according to sarcopenia vs conventional traditional eval-uation method, and to further explore the factors related to sarcopenia in patients with hepatic cirrhosis. Methods The data of patients with cirrhosis treated in our department between January 2016 and January 2017 were collected. The SGA scores, traditional nutritional indicators and the skeletal muscle index calculated via third lumbar vertebra (L3) plane on CT were used to evaluate the prevalence of malnutrition in the cirrhotic patients. Meanwhile, 52 patients with liver cirrhosis were assigned into the sarcopenia group and non-sarcopenia group. The differences in the nutrition-al indicators between the two groups were analyzed. Risk factors related to occurrence of sarcopenia were further studied using binary Logistic regression analysis. Results The prevalence of sarcopenia in 52 cirrhotic patients was 64%. There were statistically significant differences in age, sex, BMI, ALB, TSF and AMC between the two groups (P<0.05). Binary Logistic regression analysis showed that sex [OR=0.001, 95% CI (0.000, 0.223), P=0.011] and BMI [OR=0.312, 95% CI=(0.134, 0.722), P=0.007] were major risk factors for sarcopenia. Conclusion Sarcopenia may be used as an objective assessment of nutritional status in patients with hepatic cirrhosis. Male cirrhotic patients with lower BMI are more likely to have sarcopenia.
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