SMI、SI与呼吸危重症患者营养状况及预后的相关性观察

Observation of correlation between SMI,SI and nutritional status and prognosis of patients with respiratory critical illness

目的分析骨骼肌质量指数(SMI)、肌少症指数(SI)与呼吸危重症营养状况及预后的相关性。方法选取2020年5月至2022年6月在天津市北辰区中医医院接受治疗的呼吸危重患者130例,参照改良危重症营养风险评分表(mNUTRIC)对其营养状态予以测评,比较不同营养状况者SMI、SI水平。通过多因素Logistic回归模型探索呼吸危重症死亡的风险因素,利用受试者工作特征(ROC)曲线明确SMI、SI在呼吸危重症患者死亡风险中的评估价值。结果130例患者中高营养风险48例设为高风险组、低营养风险82例设为低风险组,高风险组SMI、SI低于低风险组(P<0.05)。离开ICU时,本组130例患者中36例死亡设为预后不良组、存活94例设为预后良好组,预后不良组年龄、APACHEⅡ评分及PCT水平高于预后良好组,ALB、SI和SMI则低于预后良好组(P<0.05)。多因素Logistic回归模型分析证实,高APACHEⅡ评分及低SMI、SI值为呼吸危重症病死的独立危险因素(P<0.05)。ROC证实,SMI、SI在呼吸危重症患者死亡预测中的预测AUC 0.890高于单独预测的0.784、0.726(P<0.05)。结论SMI、SI水平与呼吸危重症患者营养状况具有密切关联性,监测两者水平可对疾病病死风险予以预测评估预测患者死亡的临床价值较高。

Objective The correlation of skeletal muscle mass index(SMI)and sarcopenia index(SI)with nutritional status and prognosis of respiratory critical illness was analyzed.Methods A total of 130 critically ill respiratory patients treated in Tianjin beichen district traditional chinese medicine hospital from May 2020 to June 2022 were selected,and their nutritional status was evaluated according to the Modified Critical Illness Nutritional Risk Scale(mNUTRIC),and SMI and SI levels of different nutritional status were compared.Multivariate Logistic regression model was used to explore the risk factors of death from respiratory critically ill patients,and receiver operating characteristic(ROC)curve was used to determine the evaluation value of SMI and SI in the risk of death from respiratory critically ill patients.Results Among the 130 patients,48 cases of high nutritional risk were set as high risk group and 82 cases of low nutritional risk were set as low risk group.The SMI and SI of high risk group were lower than those of low risk group(P<0.05).At the time of leaving ICU,36 of the 130 patients died in the poor prognosis group and 94 survived in the good prognosis group.The age,APACHEⅡscore and PCT level of the poor prognosis group were higher than those of the good prognosis group,while the ALB,SI and SMI of the poor prognosis group were lower than those of the good prognosis group(P<0.05).Multivariate Logistic regression model analysis confirmed that high APACHEⅡscore and low SMI and SI values were independent risk factors for death from respiratory critical illness(P<0.05).ROC confirmed that the predicted AUC of 0.890 of SMI and SI in the death prediction of respiratory critically ill patients was higher than 0.784 and 0.726 separately(P<0.05).Conclusion The levels of SMI and SI are closely related to the nutritional status of patients with respiratory critical illness.Monitoring the levels of SMI and SI can predict and evaluate the risk of disease and death,and it has high clinical value to predict the death of patients.