慢性肾脏病患者的肌肉含量变化及其影响因素分析

Changes of muscle content and its influencing factors in patients with chronic kidney disease

目的探讨慢性肾脏病(CKD)患者的肌肉含量变化及其影响因素。方法入选患者200例,根据估计肾小球滤过率(eGFR)将其分为A、B、C三组,使用人体成分分析仪(BCM)分别评估三组患者的瘦组织指数(LTI),比较三组患者肌肉质量的变化。收集所有患者的相关临床资料和实验室指标,以LTI值为因变量行多因素线性回归分析。结果A、B、C三组间LTI差异有统计学意义(P<0.05),B组较A组患者LTI显著下降,C组较B组患者LTI显著下降(P<0.05)。低LTI患者的年龄、收缩压、脂肪指数、糖尿病占比、尿蛋白肌酐比值高于正常LTI组,男性占比、体质量指数(BMI)、血清白蛋白、心血管疾病占比和总胆固醇水平低于正常LTI组(P<0.05),多因素线性回归分析表明,男性、年龄、糖尿病、脂肪指数、心血管疾病是肌肉质量的主要影响因素(P<0.05)。结论CKD患者肌肉含量随肾小球滤过率下降而下降。男性、年龄、脂肪指数、心血管疾病、糖尿病是肌肉质量的主要影响因素。

【Objective】To investigate the changes of muscle content and its influencing factors in patients with chronic kidney disease(CKD).【Methods】Two hundred patients were divided into three groups according to estimated glomerular filtration rate(e GFR).The lean tissue index(LTI)of the three groups was evaluated by body composition analyzer(BCM),and the changes of muscle mass in the three groups were compared.The relevant clinical data and laboratory indexes of all patients were collected,and the LTI value was used as a dependent variable for multivariate linear regression analysis.【Results】There was significant difference in LTI among groups A,B and C.LTI in group B was significantly lower than that in group A,and LTI in group C was significantly lower than that in group B.The age,systolic blood pressure,fat index,proportion of diabetes and urinary protein/creatinine ratio of patients with low LTI were higher than those of normal LTI group,while male proportion,BMI,serum albumin,the proportion of cardiovascular disease and total cholesterol levels were lower than those of normal LTI group.The differences were statistically significant(P<0.05).Multivariate linear regression analysis showed that male,age,diabetes,fat index and cardiovascular disease were the main influencing factors of muscle mass(P<0.05).【Conclusion】The muscle content of CKD patients decreased with the decrease of glomerular filtration rate.Male,age,fat index,cardiovascular disease and diabetes are the main influencing factors of muscle mass.