肱二头肌超声参数联合临床资料诊断慢性肾脏病患者蛋白质能量消耗的临床价值

马彧靓; 何正中; 赵琳; 阚艳敏; 周燕; 经翔; 王洪玲

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肱二头肌超声参数联合临床资料诊断慢性肾脏病患者蛋白质能量消耗的临床价值

临床研究 | 更新时间：2023-10-11

- 肱二头肌超声参数联合临床资料诊断慢性肾脏病患者蛋白质能量消耗的临床价值
- Diagnostic value of ultrasound measurement of biceps brachii in protein energy consumption
- 临床超声医学杂志 2023年25卷第5期
- 作者机构：
  
  1. 天津市第三中心医院超声科,300170
  2. 天津市第三中心医院肾内科,300170
  3. 天津市重症疾病体外生命支持重点实验室,300170
  4. 天津市人工细胞工程技术研究中心,300170
  5. 天津市肝胆研究所,300170
- 作者简介：
- 基金信息：
- DOI：
  中图分类号：
- 纸质出版日期：2023，
  
  网络出版日期：2023-5-26，
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马彧靓, 何正中, 赵琳, 等. 肱二头肌超声参数联合临床资料诊断慢性肾脏病患者蛋白质能量消耗的临床价值[J]. 临床超声医学杂志, 2023,25(5).

Diagnostic value of ultrasound measurement of biceps brachii in protein energy consumption[J]. Journal of Clinical Ultrasound in Medicine, 2023,25(5).
马彧靓, 何正中, 赵琳, 等. 肱二头肌超声参数联合临床资料诊断慢性肾脏病患者蛋白质能量消耗的临床价值[J]. 临床超声医学杂志, 2023,25(5). DOI：

Diagnostic value of ultrasound measurement of biceps brachii in protein energy consumption[J]. Journal of Clinical Ultrasound in Medicine, 2023,25(5). DOI：

摘要

摘要目的探讨超声测量肱二头肌在评估蛋白质能量消耗状态（Protein Energy Wasting，PEW）中的诊断价值。方法回顾性收集自2019年1月至2021年9月于天津市第三中心医院肾内科血液净化中心接受血液透析治疗的慢性肾病（Chronic Kidney Disease，CKD）患者83例，其中男性50例，女性33例，年龄27-87岁（中位年龄63岁），比较患者肱二头肌超声测量数据在PEW不同组间的差异并分析其在评估PEW过程中的诊断价值。结果体重指数（Body Mass Index，BMI）和肱二头肌舒张纵径在患者不同性别及蛋白摄入量正常的前提下，对PEW有一定的诊断价值（AUC>0.70）。男性与女性BMI低于截断值会增加PEW的患病风险，差异具有统计学意义（OR=8.384，95%CI 1.565-44.908，P<0.05），男性与女性肱二头肌舒张纵径低于截断值会增加PEW的患病风险，差异具有统计学意义（OR=8.847，95%CI 1.052-52.105，P<0.05）；对于蛋白摄入量正常的患者，BMI低于截断值会增加PEW的患病风险，差异具有统计学意义（OR=5.121，95%CI 1.053-24.901，P<0.05），肱二头肌舒张纵径低于截断值会增加PEW的患病风险，差异具有统计学意义（OR=8.437，95%CI 1.384-51.447，P<0.05）。结论肱二头肌舒张纵径可以作为诊断PEW的辅助评判标准，在BMI降低的CKD病人中应用超声手段测量肱二头肌舒张纵径可以明确患者肌肉萎缩情况，对PEW的诊断具有重要价值。

Abstract

Objective This study aimed to investigate the diagnostic efficacy of ultrasound measuring musculus biceps brachii in the diagnosis of protein energy wasting (PEW) in patients with hemodialysis (HD). Methods A retrospective collection of Chronic Kidney Disease (CKD) patients who received hemodialysis treatment in blood Purification Center

Department of Nephrology

Tianjin Third Central Hospital from January 2019 to September 2021 had been done. There were totally 83 patients

including 50 males and 33 females

aged 27-87(median age 63). The differences of biceps brachii ultrasound measurement data among different PEW groups had been compared and their diagnostic value of assessing PEW had been analyzed. Results BMI and longitudinal diastolic diameter of muscle biceps brachii showed certain diagnostic value for the state of protein energy wasting under the condition of different genders and normal protein intake (AUC>0.70). BMI lower than the cut-off value in men and women increased the risk of PEW

and the difference was statistically significant (OR=8.384

95%CI 1.565-44.908

P<0.05); the longitudinal diastolic diameter of muscle biceps brachii lower than the cut-off value in men and women increased the risk of PEW

and the difference was statistically significant (OR=8.847

P<0.05). 95%CI 1.052-52.105

P<0.05). For patients with normal protein intake

the BMI lower than the cut-off value increased the risk of PEW

and the difference was statistically significant (OR=5.121

95%CI 1.053-24.901

P<0.05); the longitudinal diastolic diameter of muscle biceps brachii lower than the cut-off value increased the risk of PEW

and the difference was statistically significant (OR=8.437

95%CI 1.384-51.447

P<0.05). Conclusion The longitudinal diastolic diameter of muscle biceps brachii can be used as an auxiliary diagnostic criterion for the diagnosis of PEW. The state of the amyotrophy of the CKD patients with reduced BMI can be identified by the ultrasound measurement of longitudinal diastolic diameter of muscle biceps brachii

which could be a high-value diagnosis for protein energy wasting.

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