克罗恩病发生肌少症的危险因素研究-东南大学学报医学版

克罗恩病发生肌少症的危险因素研究

单位：南通大学附属江阴医院消化内科, 江苏江阴 214400

分类号：R574

出版年·卷·期（页码）：2023·42·第六期（896-902）

摘要：

目的:分析克罗恩病(CD)发生肌少症的危险因素。方法:回顾性分析2018年1月至2023年2月至南通大学附属江阴医院住院治疗的121例CD患者的临床资料,提取腹部计算机断层扫描(CT)结果,使用Image J软件测量患者第3腰椎横截面肌肉面积,计算骨骼肌指数。根据计算结果将患者分为肌少症组及非肌少症组,比较两组患者的临床资料,采用Logistic回归分析CD发生肌少症的危险因素。结果:121例CD患者中77例(63.6%)患有肌少症。Logistic 多因素回归分析显示:年龄大(OR=1.107)、1年内有并发症(OR=3.582)、NRS-2002评分高(OR=2.081)为CD发生肌少症的危险因素(均P＜0.05);确诊年龄早(OR=0.851)为CD发生肌少症的保护因素(P＜0.05)。将筛选出的危险因素构建诺模图,诺模图的C指数为0.820。结论:年龄越大、1年内有肠道并发症、NRS-2002评分越高、确诊年龄越早会增加CD患者发生肌少症的风险。诺模图能对CD患者发生肌少症的风险进行准确预测,以便为早期进行临床决策提供帮助。

Objective: To explore the risk factors for sarcopenia in Crohn's disease(CD). Methods: A retrospective study was conducted to analyze medical records of patients who diagnosed with CD. A total of 121 CD patients admitted to Jiangyin Hospital Affiliated to Nantong University from January 2018 to February 2023 were included. The abdominal Computed Tomography(CT) results were extracted, and the skeletal muscle index was calculated with Image J software.Patients were divided into sarcopenia group and non-sarcopenia group. The differences of basic characteristic and cilical markers between the two groups were evaluated.Logistic regression analysis was used to identify the risk factors for sarcopenia in CD patients. Results: Among the 121 CD patients included in this study, 77(63.6%) patients had sarcopenia.Multivariate Logistic regression analysis showed that big age(OR=1.107), complications within 1 year(OR=3.582), and high NRS-2002 nutritional score(OR=2.081) were risk factors for sarcopenia in CD(all P<0.05).The early age of diagnosis(OR=0.851) was a protective factor for sarcopenia in CD(P<0.05). Then a nomogram was constructed for predicting the occurrence of sarcopenia in CD, the C-index was 0.820. Conclusion: The older the age, the more intestinal complications occur within one year, the higher the NRS-2002 score, and the earlier the age of diagnosis will increase the risk of sarcopenia in CD patients.Nomogram can accurately predict the incidence of sarcopenia in CD, providing assistance for early clinical decision-making.

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