中华保健医学杂志

目的 分析维持性血液透析(MHD)患者发生肌少症的危险因素。方法 收集2021年1月～2023年2月于六安市中医院行血液透析患者151例。采用亚洲肌少症工作组标准诊断肌少症46例(肌少症组),其他105例患者为非肌少症组。使用改良定量主观整体评估问卷(MQSGA)评估患者的营养状况。对肌少症组和无肌少症组的一般临床资料、实验室指标、透析相关指标进行比较。采用logistic回归进行多元影响因素分析。结果 肌少症组的体质量指数(BMI)、白蛋白、前白蛋白、肌酐、二氧化碳结合力低于非肌少症组，年龄、糖尿病患者占比、MQSGA评估营养不良占比、超敏C反应蛋白高于非肌少症组，组间差异有统计学意义(P<0.05)。logistic多因素回归分析发现年龄、合并糖尿病、营养不良、超敏C反应蛋白、二氧化碳结合力是影响肌少症发生的独立危险因素(P<0.05)。结论 年龄增加、合并糖尿病、营养不良、超敏C反应蛋白升高、二氧化碳结合力降低是影响MHD患者肌少症发生的独立危险因素，需根据MHD患者特点，尽早识别，实施个体化的干预方案。

Objective To analyze the risk factors for sarcopenia in maintenance hemodialysis(MHD) patients.Methods Data of 151 patients undergoing hemodialysis in our hospital from January 2021 to February 2023 were collected. According to the criteria of the Asian working group, 46 patients diagnosed with sarcopenia were assigned to the sarcopenia group, while 105 patients without sarcopenia were diagnosed as the non-sarcopenia group. General clinical data, laboratory indicators and dialysis related indicators were compared between the sarcopenia and non-sarcopenia groups. Logistic regression was utilized to conduct a multiple influencing factor analysis.Results BMI, albumin, prealbumin, creatinine, and carbon dioxide binding capacity in the sarcopenia group were lower than those in the non-sarcopenia group, while age, the proportion of diabetes patients, the proportion of malnutrition assessed by MQSGA, and high-sensitivity C-reactive protein were higher than those in the non-sarcopenia group(P < 0.05). Logistic regression analysis showed that age, diabetes, malnutrition, high-sensitivity C-reactive protein and carbon dioxide binding capacity were independent risk factors for myopenia(P < 0.05).Conclusion Age, diabetes, malnutrition, high sensitivity C-reactive protein and low carbon dioxide binding capacity are independent risk factors for myopenia in MHD patients.Early identification based on the characteristics of MHD patients and the implementation of individualized intervention programs are essential.