乙型肝炎肝硬化患者营养状况及肌少症发生率调查

Prevalence of nutrition and sarcopenia in patients with hepatitis B-induced liver cirrhosis

目的探讨乙型肝炎肝硬化患者营养状况及肌少症发生的危险因素。方法2019年1月~2023年12月我院收治的乙型肝炎肝硬化患者156例,采用主观综合性营养评估法(SGA)进行营养风险筛查,使用生物电阻抗分析法(BIA)测量四肢骨骼肌肌肉质量(ASM),计算相对骨骼肌质量指数(ASMI),诊断肌少症。采用多因素Logistic回归分析影响乙型肝炎肝硬化患者发生肌少症的因素。结果本组156例肝硬化患者营养不良发生率为59.0%,肌少症发生率为29.5%,其中39例Child-Pugh A级组营养不良和肌少症发生率分别为20.5%和7.7%,48例B级分别为50.0%和25.0%,69例C级分别为87.0%和44.9%,组间差异(P<0.05);46例肌少症组年龄、BMI、血清ALB和SGA评分分别为(64.1±12.5)岁、(19.3±2.2)kg/m^(2)、(24.1±3.9)g/L和(21.3±3.4)分,与110例非肌少症组【分别为(54.7±11.2)岁、(23.9±3.0)kg/m^(2)、((34.3±4.8)g/L和(28.7±4.0)分】比,差异有统计学意义(P<0.05);Logistic回归分析显示,BMI(OR=0.683)、血清ALB(OR=0.631)和SGA评分(OR=0.653)均为显著影响乙型肝炎肝硬化患者肌少症发生的独立危险因素(P<0.05)。结论乙型肝炎肝硬化患者伴有营养不良较普遍,肌少症发生风险较高。了解风险因素,做好早期筛查可能指导及时处理。

Objective The aim of this study was to investigate prevalence of nutrition and sarcopenia in patients with hepatitis B-induced liver cirrhosis(LC).Methods 156 patients with hepatitis B-induced LC were encountered in our hospital between January 2019 and December 2023,subjective global assessment(SGA)was applied to screen nutritional risk,and sarcopenia was diagnosed based on criteria proposed out by Asian Working Group for Sarcopenia 2019(AWGS2019).Multivariate Logistic regression analysis was used to predict risk factors for sarcopenia.Results Of 156 patients in our series,incidence of malnutrition was 59.0%and incidence of sarcopenia was 29.5%,and they were 20.5%and 7.7%in 39 patients with Child-Pugh class A,50.0%and 25.0%in 48 patients with class B and 87.0%and 44.9%in 69 patients with class C,significantly different among them(P<0.05);age,basic mass index(BMI),serum albumin level and SGA score in 46 patients with sarcopenia were(64.1±12.5)yr,(19.3±2.2)kg/m^(2),(24.1±3.9)g/L and(21.3±3.4)points,significantly different as compared to[(54.7±11.2)yr,(23.9±3.0)kg/m^(2),((34.3±4.8)g/L and(28.7±4.0)point,all P<0.05]in 110 patients without sarcopenia;multivariate Logistic regression analysis showed that BMI(OR=0.683),serum albumin level(OR=0.631)and SGA score(OR=0.653)were all risk factors for occurrence of sarcopenia in patients with LC(P<0.05).Conclusion Malnutrition is common in patients with hepatitis B-induced LC,and the risk of sarcopenia is also relatively high.Clinicians should take these incidents into consideration and deal with as early as possible.