不同肌肉减少症检查工具在老年共病患者营养评定中的诊断效能分析

宁传荣; 李倩; 张燕; 方世同; 黄昌保; 汪镜静

doi:10.16766/j.cnki.issn.1674-4152.004128

不同肌肉减少症检查工具在老年共病患者营养评定中的诊断效能分析

doi: 10.16766/j.cnki.issn.1674-4152.004128

1.
马鞍山市人民医院全科医学科, 安徽马鞍山 243000
2.
皖南医学院弋矶山医院急诊内科，安徽芜湖 241000
3.
马鞍山市人民医院消化科

基金项目:

安徽省高等学校科研计划项目 2022AH040168

详细信息

通讯作者:
李倩，E-mail：Lq620903@163.com

中图分类号: R592
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- 文章访问数: 9
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- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-08-09
- 网络出版日期: 2025-10-31

Analysis of diagnostic efficacy of different sarcopenia diagnostic tools in senile comorbid patients with normal nutrition and malnutrition

1.
General Practice Department of Ma'anshan People's Hospital, Ma'anshan, Anhui 243000, China

摘要

摘要: 目的分析不同肌肉减少症检查工具在老年共病患者营养评定中的诊断效能，为临床选择更为快捷且简便的营养评估方案提供参考。方法选择2021年8月—2024年4月马鞍山市人民医院收治的242例老年共病患者为研究对象，以微型营养评定法(MNA)诊断结果作为营养状态评定金标准，并将其分为营养正常组和营养不良组，分别采用改良版肌肉减少症五条目(SARC-CalF)问卷、简易五项评分(SARC-F)问卷以及Ishii评分3种常用肌肉减少症筛查工具对患者营养状态进行调查，分析3种不同肌肉减少症检查工具对老年共病患者营养状态情况的诊断价值。结果通过MNA对242例老年共病患者的营养状态进行评估发现，其中营养不良者98例，营养正常者144例；以MNA问卷为诊断标准，SARC-CalF问卷、SARC-F问卷、Ishii评分对老年共病病人营养状态的诊断灵敏度分别为83.5%、73.7%、77.0%，特异度分别为94.7%、89.1%、91.5%，准确度分别为89.7%、81.8%、84.7%。一致性检验显示，SARC-CalF问卷、SARC-F问卷、Ishii评分与金标准的Kappa值分别为0.789、0.632、0.690；其中SARC-CalF对老年共病患者营养评定的诊断效能稍高于其他两种肌肉减少症检查工具。结论 SARC-CalF、SARC-F及Ishii评分三种常用的肌肉减少症检查工具对老年共病患者营养评定具有一定的诊断价值，其中SARC-CalF对老年共病患者营养评定的灵敏度和特异度相对更高。
- 肌肉减少症检查工具 /
- 营养评定 /
- 改良版肌肉减少症五条目问卷 /
- 简易五项评分问卷 /
- Ishii评分
Abstract: Objective To analyze the diagnostic efficacy of different sarcopenia examination tools in the nutritional assessment of elderly patients with comorbidities. The results of this study will provide a reference for clinical selection of a faster and simpler nutritional assessment scheme. Methods A total of 242 elderly patients suffering from multiple chronic conditions were selected for inclusion in the study. These patients were admitted to Ma'anshan People's Hospital between August 2021 and April 2024. The mini nutritional assessment (MNA) diagnostic results were utilized as the gold standard for the evaluation of nutritional status, and the patients were categorized into two groups based on their nutritional status: a normal nutrition group and a malnutrition group. Three commonly used sarcopenia screening tools were employed to investigate the nutritional status of the patients: the modified 5-item scale (SARC-CalF) questionnaire, the simple sarcopenia screen (SARC-F) questionnaire, and the Ishii score. The present study sought to analyze the diagnostic value of these three different sarcopenia screening tools in assessing the nutritional status of elderly patients with multiple chronic conditions. Results The nutritional status of 242 senile patients with comorbidities was evaluated by means of the MNA. Among the subjects, 98 exhibited signs of malnourishment, while 144 demonstrated a healthy nutritional status. The utilization of the MNA questionnaire as the diagnostic criteria revealed the diagnostic sensitivity of the SARC-CalF questionnaire, SARC-F questionnaire and Ishii score for the nutritional status of elderly comorbidities was to be 83.5%, 73.7%, and 77.0%, respectively. Concurrently, the respective specificities were determined to be 94.7%, 89.1%, and 91.5%. The accuracy of the model was 89.7%, 81.8% and 84.7%, respectively. The consistency test demonstrated that the Kappa values of the SARC-CalF questionnaire, the SARC-F questionnaire, the Ishii score, and the gold standard were 0.789, 0.632, and 0.690, respectively. The diagnostic efficacy of SARC-CalF in senile comorbidities was marginally superior to that of the other two SARC-CALF diagnostic tools. Conclusion The SARC-CalF, SARC-F and Ishii score are three commonly used diagnostic tools for the nutritional assessment of senile comorbidities. The SARC-CalF demonstrates relatively higher sensitivity and specificity for the nutritional assessment of senile comorbidities.
- Sarcopenia test tool /
- Nutritional assessment /
- Modified sarcopenia five-item questionnaire /
- Simple five-item scoring questionnaire /
- Ishii score

HTML全文

图 1 3种肌肉减少症检查工具的ROC曲线

Figure 1. ROC curves of three sarcopenia examination tools

下载: 全尺寸图片幻灯片

表 1 2组老年共病患者一般资料比较

Table 1. Comparison of general data between two groups of elderly patients with comorbidities

组别	例数	性别(例)		年龄 (x±s，岁)	居住地(例)		共病数量 (x±s)
组别	例数	男性	女性	年龄 (x±s，岁)	农村	城镇	共病数量 (x±s)
营养不良	98	41	57	72.65±7.59	47	51	3.22±0.67
营养正常	144	58	86	71.42±7.66	66	79	3.10±0.54
统计量		0.058^a		1.231^b	0.106^a		1.538^b
P值		0.809		0.220	0.745		0.125
注：^a为χ²值，^b为t值。

下载: 导出CSV

表 2 3种肌肉减少症检查工具对老年共病患者营养状态诊断的效果

Table 2. The effects of three sarcopenia examination tools on the diagnosis of nutritional status in elderly patients with comorbidities

项目	灵敏度(%)	特异度(%)	准确度(%)	约登指数
SARC-CalF	83.5(91/109)	94.7(126/133)	89.7(217/242)	0.804
SARC-F	73.7(84/114)	89.1(114/128)	81.8(198/242)	0.649
Ishii评分	77.0(87/113)	91.5(118/129)	84.7(205/242)	0.707
χ²值	3.214	2.815	6.120
P值	0.201	0.245	0.047

下载: 导出CSV

表 3 3种肌肉减少症检查工具的诊断效能分析

Table 3. Analysis of the diagnostic efficacy of three sarcopenia examination tools

项目	AUC	95% CI	SE	P值
SARC-CalF	0.902	0.857~0.936	0.019	< 0.001
SARC-F	0.824	0.771~0.870	0.025	< 0.001
Ishii评分	0.854	0.803~0.896	0.023	< 0.001

下载: 导出CSV

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