克罗恩病患者第三腰椎骨骼肌指数在营养评估中的价值

目的探讨克罗恩病(CD)患者第三腰椎骨骼肌指数(L3-SMI)与临床指标和营养状况的相关性。方法回顾性分析2018年6月至2022年10月156例住院期间腰椎CT检查的CD患者的临床资料,记录一般资料、实验室检查结果及营养风险筛查2002(NRS2002)评分,计算L3-SMI,比较不同L3-SMI水平患者的特点。结果低L3-SMI组患者的年龄、身高、NRS2002评分≥3分、血小板计数、红细胞沉降率、超敏C反应蛋白、粪钙卫蛋白明显高于高L3-SMI组,低L3-SMI组的BMI、25-羟基维生素D、总蛋白、白蛋白、血红蛋白、淋巴细胞计数明显低于高L3-SMI组,差异有统计学意义(P<0.01或<0.05)。Spearman相关结果显示,L3-SMI与BMI(r=0.996)、25-羟基维生素D(r=0.978)、白蛋白(r=0.999)、血红蛋白(r=0.552)、淋巴细胞绝对数(r=0.244)呈正相关;与NRS2002评分≥3分(r=-0.387)、血小板计数(r=-0.271)、红细胞沉降率(r=-0.988)、超敏C反应蛋白(r=-0.984)、粪钙卫蛋白(r=-0.906)呈负相关。结论L3-SMI对于CD患者的营养状况评估有一定的价值,可作为CD患者营养不良的综合评估方法。

Objective To discusses the third lumbar skeletal muscle index(L3-SMI)and its correlation with clinical indicators and nutritional status in Crohn's disease(CD)patients.Methods This retrospective analysis included the clinical data of 156 CD patients who were admitted to the Department of Gastroenterology in our hospital from June 2018 to October 2022.We recorded the general clinical data,laboratory test results,and the score of nutritional risk screening 2002(NRS2002).We calculated the L3-SMI and compared these variables with patients with different L3-SMI levels.Results The low L3-SMI group had significantly higher age,height,number of NRS2002≥3,platelet count,erythrocyte sedimentation rate,high-sensitivity C-reactive protein,and faecal calprotectin than the high L3-SMI group.Conversely,the low L3-SMI group had significantly lower BMI,25-Hydroxyvitamin D,total protein,albumin,haemoglobin,and lymphocyte count than the high L3-SMI group.Spearman's correlation analysis indicated that L3-SMI was positively correlated with BMI,25-hydroxyvitamin D,albumin,haemoglobin,and an absolute number of lymphocytes.In contrast,it was negatively correlated with NRS2002≥3,platelet count,erythrocyte sedimentation rate,high-sensitivity C-reactive protein,and faecal calprotectin.Conclusion L3-SMI has a certain value in evaluating the nutritional status of CD patients and can be used as a comprehensive evaluation method for malnutrition in CD patients.