5种肌少症评估工具筛查维持性血液透析患者肌少症效果比较

Comparison of five screening tools for sarcopenia in maintenance hemodialysis patients

目的比较5种肌少症评估工具在维持性血液透析人群中的诊断效能,为早期筛查肌少症风险提供可行性评估工具。方法选取130例维持性血液透析患者为研究对象,分别使用简易5项评分量表(SARC-F)、SARC-CalF评分量表、Ishii评分和中文版迷你肌少症风险评估量表(包括7条目量表和5条目量表)对其进行筛查。分别采用老年人肌少症欧洲工作组、亚洲肌少症工作组、美国国立卫生研究院基金会和肌少症国际工作组制定的标准作为诊断标准,计算5种评估工具的的灵敏度、特异度、约登指数及受试者操作特征曲线下面积。结果采用前3种标准时,Ishii评分的受试者操作特征曲线下面积分别为0.793、0.871和0.752,在同类标准下最大;采用肌少症国际工作组标准时,SARC-CalF评分的受试者操作特征曲线下面积为0.739,同类中最大。结论5种肌少症评估工具中,Ishii评分是筛查维持性血液透析患者肌少症风险的首优选择,其次推荐SARC-CalF评分。

Objective To compare the performance of five screening tools for sarcopenia in patients on maintenance hemodialysis(MHD),and to provide practical tools for early assessment of the risk of sarcopenia.Methods A total of 130 MHD patients were selected and screened for sarcopenia using Strength,Assistance with Walking,Rise from a Chair,Climb Stairs and Falls(SARC-F)sarcopenia score,the SARC-F combined with calf circumference(SARC-CalF),the Ishii Score,and two versions of the Mini Sarcopenia Risk Assessment(MSRA-7 and MSRA-5)questionnaire.Four common diagnostic criteria(EWGSOP2,AWGS2,IWGS,and FNIH)were utilized as the standard diagnostic methods.The sensitivity,specificity,Youden index and area under the receiver operating characteristic(ROC)curves(AUC)were calculated.Results Using diagnostic criteria of the EWGSOP2,AWGS2,and IWGS,the Ishii Score had the largest AUC among the five screening tools(0.793,0.871,and 0.752 respectively).Using diagnostic criteria of the FNIH,the AUC of SARC-CalF was the largest(0.739).Conclusion Among the five screening tools,the Ishii Score is most recommended for screening sarcopenia in MHD patients,followed by SARC-CalF.