| 徐佳美,刘丹,郭艳香,翁宁,童孟立.老年腹膜透析肌少症发生率及对短期生存预后的影响[J].浙江中西医结合杂志,2025,35(8): |
| 老年腹膜透析肌少症发生率及对短期生存预后的影响 |
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| 投稿时间：2024-08-20 修订日期：2025-01-10 |
| DOI： |
| 中文关键词: 腹膜透析 肌少症 预后 老年 |
| 英文关键词:peritoneal dialysis sarcopenia mortality Aged |
| 基金项目:浙江省医药卫生科技计划项目, 2023KY200 |
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| 中文摘要: |
| 目的 ?探讨老年腹膜透析患者肌少症发生情况,及对患者生存预后的影响。方法 ?采用前瞻性队列研究,于2021年9月-11月收集杭州市中医院腹膜透析(peritoneal dialysis,PD)中心在透且规律随访的60岁以上PD患者一般资料,实验室指标、四肢骨骼肌质量指数(appendicular muscle mass index,ASMI)、肌肉力量、躯体功能。根据诊断标准分为肌少症组和非肌少症组,随访24个月,记录患者生存情况。采用Kaplan-Meier生存曲线分析肌少症、ASMI、肌肉力量、躯体功能分别与患者全因死亡率的关系,进一步COX回归分析。结果 ?共纳入老年PD患者106例,其中男性56例,女性50例；年龄(67.73±3.79)岁；透析龄中位数48.73(23.7,94.07)月；肌少症组27(25.5%)例,非肌少症组79(74.5%)例。随访期间,肌少症组死亡8例(29.6%),感染和心血管疾病是主要死亡原因；非肌少症组死亡4例(5.1%),其中3例死于心血管疾病。肌少症、低ASMI是全因死亡的独立风险预测因素。结论? 老年PD患者肌少症发生率较高,需引起重视,肌少症、低ASMI是老年PD患者全因死亡的独立危险因素。 |
| 英文摘要: |
| Objective? Investigation of Sarcopenia in Elderly Peritoneal Dialysis Patients and Its Impact on Patient Prognosis.? Methods? A prospective cohort study was conducted from September to November 2021 at the Peritoneal Dialysis Center of Hangzhou Hospital of Traditional Chinese Medicine. General information, laboratory indicators, appendicular muscle mass index (ASMI), muscle strength, and physical function were collected for PD patients aged 60 years and above who were regularly followed up. Based on diagnostic criteria, patients were divided into the sarcopenia group and non-sarcopenia group. Patients were followed up for 24 months, and their survival status was recorded. Kaplan-Meier survival curves were used to analyze the relationship between sarcopenia, ASMI, muscle strength, physical function, and all-cause mortality rate. Further COX regression analysis was performed.? Results? A total of 106 elderly PD patients were included in the study, including 56 males and 50 females. The mean age was (67.73±3.79) years. The median dialysis vintage was 48.73 (23.7, 94.07) months. There were 27 cases (25.5%) in the sarcopenia group and 79 cases (74.5%) in the non-sarcopenia group. During the follow-up period, there were 8 deaths (29.6%) in the sarcopenia group, with infection and cardiovascular disease being the main causes of death. In the non-sarcopenia group, there were 4 deaths (5.1%), with 3 of them attributed to cardiovascular disease. Sarcopenia and low appendicular skeletal muscle mass index (ASMI) were identified as independent risk factors for all-cause mortality.? Conclusions? The occurrence rate of sarcopenia is higher in elderly PD patients, which requires attention. Sarcopenia and low ASMI are independent risk factors for all-cause mortality in elderly PD patients. |
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