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Crit Care Med:通过肾功标志物预测肌肉质量

2016-09-16 Mechront 译 MedSci原创

肌肉减少症与ICU不良预后有关,本回顾性队列研究的目的是,利用常规肾功能指标,描述简单的肌肉减少症指数,并评估其与患者肌肉质量和结局的关系。 研究纳入了2008年10月至2010年12月、三级医疗中心例的高危ICU成人患者。通过腹部CT扫描,根据L4椎体椎旁肌表面面积,对肌肉质量的金标准进行了量化。采用皮尔森相关系数,发现血清肌酐/血清胱抑素C比是评估肌肉质量的最佳指标。研究者评估了肌肉减少

肌肉减少症与ICU不良预后有关,本回顾性队列研究的目的是,利用常规肾功能指标,描述简单的肌肉减少症指数,并评估其与患者肌肉质量和结局的关系。

研究纳入了2008年10月至2010年12月、三级医疗中心例的高危ICU成人患者。通过腹部CT扫描,根据L4椎体椎旁肌表面面积,对肌肉质量的金标准进行了量化。采用皮尔森相关系数,发现血清肌酐/血清胱抑素C比是评估肌肉质量的最佳指标。研究者评估了肌肉减少症指数与院内、90天死亡率、以及械通气时间之间的关系。

226例患者中,123例(54%)为女性,198例(87%)为白人。中位数(四分位距)年龄、体重指数、体表面积分别为68(57-77)岁、28 (24-34) kg/m2、1.9 (1.7-2.2) m2。平均(+/- SD)急性生理学和慢性健康评价III为70(+/- 22)。 ICU、院内和90天死亡率分别为5%、12%和20%。

肌肉减少症指数和肌肉质量之间的相关性为0.62,确定系数为0.27 (p < 0.0001)。校正急性生理和慢性健康评估III、体表面积、年龄后,肌肉减少症指数是医院死亡率(p = 0.001)和90天死亡率(p < 0.0001)的独立预测因素。其中131例患者经历了机械通气,肌肉减少症指数越高的患者,其机械通气持续时间更短(肌肉减少症指数增加10U,机械通气时间减少1天[95% CI, -1.4 to -0.2; p = 0.006])。

结果表明,肌肉减少症指数可以公正的预测ICU患者的肌肉质量,且可适度预测院内死亡率和90天死亡率;但是要注意,患者在测量时不能有急性肾损伤。

原始出处:


Kashani, Kianoush B.et al.Evaluating Muscle Mass by Using Markers of Kidney Function: Development of the Sarcopenia Index.Critical Care Medicine: September 8, 2016

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    2016-09-29 1e0e5a1fm42(暂无匿称)

    'gandong

    0

  3. 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    2016-09-22 1e10c84am36(暂无匿称)

    文章很好,非常有益

    0

  4. 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encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sat Sep 17 22:41:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128899, encodeId=dd8d128899aa, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Fri Sep 16 21:41:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128897, encodeId=0e1412889e0c, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Fri Sep 16 21:40:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128813, encodeId=910f1288139c, content=学习了,很好。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Fri Sep 16 20:37:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128691, encodeId=466412869170, content=学习新知识谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128692, encodeId=6edc128692f5, content=谢谢学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128645, encodeId=781d12864543, content=肌肉减少症指数可以公正的预测ICU患者的肌肉质量,且可适度预测院内死亡率和90天死亡率;但是要注意,患者在测量时不能有急性肾损伤。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 12:57:00 CST 2016, time=2016-09-16, status=1, ipAttribution=)]
    2016-09-17 智慧医人
  5. 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authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128692, encodeId=6edc128692f5, content=谢谢学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128645, encodeId=781d12864543, content=肌肉减少症指数可以公正的预测ICU患者的肌肉质量,且可适度预测院内死亡率和90天死亡率;但是要注意,患者在测量时不能有急性肾损伤。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 12:57:00 CST 2016, time=2016-09-16, status=1, ipAttribution=)]
    2016-09-16 doctorJiangchao

    继续关注

    0

  6. 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authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128692, encodeId=6edc128692f5, content=谢谢学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128645, encodeId=781d12864543, content=肌肉减少症指数可以公正的预测ICU患者的肌肉质量,且可适度预测院内死亡率和90天死亡率;但是要注意,患者在测量时不能有急性肾损伤。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 12:57:00 CST 2016, time=2016-09-16, status=1, ipAttribution=)]
    2016-09-16 doctorJiangchao

    继续学习

    0

  7. 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encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sat Sep 17 22:41:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128899, encodeId=dd8d128899aa, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Fri Sep 16 21:41:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128897, encodeId=0e1412889e0c, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], 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authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128692, encodeId=6edc128692f5, content=谢谢学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128645, encodeId=781d12864543, content=肌肉减少症指数可以公正的预测ICU患者的肌肉质量,且可适度预测院内死亡率和90天死亡率;但是要注意,患者在测量时不能有急性肾损伤。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 12:57:00 CST 2016, time=2016-09-16, status=1, ipAttribution=)]
    2016-09-16 lhl629

    学习了,很好。

    0

  8. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Fri Sep 16 21:40:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128813, encodeId=910f1288139c, content=学习了,很好。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Fri Sep 16 20:37:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128691, encodeId=466412869170, content=学习新知识谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128692, encodeId=6edc128692f5, content=谢谢学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128645, encodeId=781d12864543, content=肌肉减少症指数可以公正的预测ICU患者的肌肉质量,且可适度预测院内死亡率和90天死亡率;但是要注意,患者在测量时不能有急性肾损伤。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 12:57:00 CST 2016, time=2016-09-16, status=1, ipAttribution=)]
    2016-09-16 刘煜

    学习新知识谢谢。

    0

  9. 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authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128692, encodeId=6edc128692f5, content=谢谢学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 16 14:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128645, encodeId=781d12864543, content=肌肉减少症指数可以公正的预测ICU患者的肌肉质量,且可适度预测院内死亡率和90天死亡率;但是要注意,患者在测量时不能有急性肾损伤。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 12:57:00 CST 2016, time=2016-09-16, status=1, ipAttribution=)]
    2016-09-16 刘煜

    谢谢学习了。

    0

  10. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 16 12:57:00 CST 2016, time=2016-09-16, status=1, ipAttribution=)]
    2016-09-16 知难而进

    肌肉减少症指数可以公正的预测ICU患者的肌肉质量,且可适度预测院内死亡率和90天死亡率;但是要注意,患者在测量时不能有急性肾损伤。

    0

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