通讯作者: 过新民, guo8186@126.com

DOI：10.12201/bmr.202506.00032

The value of using ultrasound indicators of rectus femoris muscle combined with clinical data to evaluate PEW in MHD patients

• 摘要：［］目的 探究通过超声技术获取的股直肌量化指标与临床资料结合在识别慢性肾脏病(Chronic Kidney disease,CKD)维持性血液透析(maintenancehemodialysis,MHD)患者患者蛋白质能量耗竭(Protein Energy Wasting ,PEW)方面的价值。方法 选取2023年11月至2024年8月期间我院肾脏科进行规律血液透析治疗的90例CKD患者,按照PEW诊断标准分为异常组(30例,存在PEW)与对照组(60例,无PEW)；测量并比较两组患者的临床指标与股四头肌超声定量数据；通过多元Logistic回归分析筛选PEW独立预测因子；构建预测模型并绘制ROC曲线评估其诊断效能。结果 PEW组与对照组在体质量指数(BMI)、血清白蛋白(ALB)、年龄、性别及股直肌厚度(MT)、横截面积(SCA)等指标上存在显著差异(均P<0.05)；多变量分析表明BMI与股直肌厚度是CKD血液透析患者PEW的独立影响因素；基于这两项指标构建的诊断模型Logit(P)=1/1+e^-(10.292-0.378×BMI-2.992×股直肌厚度)具有良好诊断效能(AUC=0.853,95%CI:0.764-0.943,P<0.05)。结论 超声评估的股直肌厚度能客观反映CKD患者骨骼肌萎缩程度,与BMI联合构建的预测模型有助于PEW的早期识别与临床干预决策。

  关键词： 超声检查; 股直肌; 蛋白质能量消耗; 慢性肾脏病; 维持性血液透析

   

  Abstract: Objective: To explore the value of combining quantitative indicators of rectus femoris muscle obtained through ultrasound technology with clinical data in identifying protein energy depletion (PEW) in patients with chronic kidney disease (CKD) undergoing maintenance hemodialysis (MHD). Methods: 90 CKD patients undergoing regular hemodialysis treatment at our hospitals nephrology department from November 2023 to August 2024 were selected and divided into an abnormal group (30 cases with PEW) and a control group (60 cases without PEW) according to PEW diagnostic criteria. Clinical indicators and quadriceps ultrasound quantitative data were measured and compared between the two groups. Independent predictors of PEW were screened through multivariate logistic regression analysis. A prediction model was constructed and ROC curves were drawn to evaluate its diagnostic performance. Results: Significant differences were observed between the PEW group and the control group in body mass index (BMI), serum albumin (ALB), age, gender, rectus femoris thickness (MT), and cross-sectional area (SCA) (all P<0.05). Multivariate analysis showed that BMI and rectus femoris thickness were independent factors affecting PEW in CKD patients. A diagnostic model based on these two indicators, Logit(P)=1/1+e^-(10.292-0.378×BMI-2.992×rectus femoris thickness),

  Key words: Ultrasonography; rectus femoris muscle; Protein Energy Expenditure; Chronic Kidney Disease; Maintenance Hemodialysis

  提交时间：2025-06-14

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• 序号	提交日期	编号	操作
  1	2025-04-26	bmr.202506.00032V1	下载

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