临床肝胆病杂志2025，Vol.41Issue(4)：698-702,5.DOI:10.12449/JCH250415
第三腰椎骨骼肌质量指数对慢加急性肝衰竭患者预后的预测价值
Value of third lumbar skeletal muscle mass index in predicting the prognosis of patients with acute-on-chronic liver failure
摘要
Abstract
Objective To investigate the value of third lumbar skeletal muscle mass index(L3-SMI)in predicting the long-term prognosis of patients with acute-on-chronic liver failure(ACLF),and to provide a useful tool for prognostic scoring of ACLF patients.Methods A retrospective analysis was performed for the data of 126 patients who underwent abdominal computed tomography(CT)scanning and were diagnosed with ACLF in Shanxi Bethune Hospital from December 2017 to December 2021,including clinical indicators,biochemical parameters,and model for end-stage liver disease(MELD)score,and L3-SMI was calculated.The independent-samples t test was used for comparison of normally distributed continuous data between groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups;the chi-square test was used for comparison of categorical data between groups.The receiver operating characteristic(ROC)curve was used to assess the diagnostic value of L3-SMI and other variables(MELD score and Child-Pugh score),and the DeLong test was used for comparison of the area under the ROC curve(AUC).Results Among the 126 patients enrolled,44(35%)died within 2 years and 82(65%)survived.Compared with the survival group,the death group had significantly higher age,incidence rate of ascites,international normalized ratio,MELD score,and Child-Pugh score(all P<0.05)and a significantly lower value of L3-SMI[38.40(35.95-46.29)cm2/m2 vs 44.19(40.20-48.58)cm2/m2,Z=-2.855,P=0.004].L3-SMI had an AUC of 0.720 in predicting 2-year mortality in ACLF patients,with a sensitivity of 63.6%and a specificity of 80.5%,and a combination of L3-SMI,MELD score,and Child-Pugh score had a significantly better AUC than a combination of MELD score and Child-Pugh score in predicting 2-year mortality(0.809 vs 0.757,Z=2.015,P<0.05).Conclusion L3-SMI has a high predictive value for the prognosis of ACLF patients,and the combination of L3-SMI、MELD score and Child-Pugh score has a higher predictive value for ACLF patients,and the inclusion of L3-SMI or sarcopenia in the conventional prognostic scores of ACLF patients may increase the ability to predict disease progression.关键词
慢加急性肝功能衰竭/第三腰椎骨骼肌质量指数/肌减少症Key words
Acute-On-Chronic Liver Failure/the Third Lumbar Skeletal Muscle Mass Index/Sarcopenia引用本文复制引用
韩冶文,李京,赵凝慧,姚佳,王娟..第三腰椎骨骼肌质量指数对慢加急性肝衰竭患者预后的预测价值[J].临床肝胆病杂志,2025,41(4):698-702,5.基金项目
山西省基础研究项目(202103021224341,202203021222342,202303021212328) （202103021224341,202203021222342,202303021212328）
山西省卫生健康委科技指导项目(2021XM42) （2021XM42）
山西省内分泌与代谢疾病重点实验室(202104010910009)Shanxi Province Basic Research Program(202103021224341,202203021222342,202303021212328) （202104010910009）
Shanxi Provincial Healthy Commission Guiding Science and Technology Project(2021XM42) （2021XM42）
Endocrine and Metabolic Diseases Key Laboratory of Shanxi Province(202104010910009) （202104010910009）
