社区慢性病共病老年患者肌少症筛查工具的比较研究

doi:10.3761/j.issn.0254-1769.2022.24.011

摘要/Abstract

摘要：

目的比较指环测试与小腿围对社区慢性病共病老年患者肌少症的筛查效果。方法 2022年2月—5月，采用方便抽样法，选取河南省郑州市15个社区的慢性病共病老年患者330例，分别应用指环测试、小腿围对其进行评估，基于2019年亚洲肌肉减少症工作组提出的诊断标准，采用SPSS 26.0软件计算灵敏度、特异度和预测值，绘制受试者操作特征曲线，计算曲线下面积，并通过约登指数，确定小腿围的最佳截断值。结果最终纳入320例社区慢性病共病老年患者，肌少症的发生率为20.63%，指环测试、小腿围的筛查率分别为28.13%、21.25%。2种肌少症筛查工具在社区慢性病共病老年患者中的灵敏度为68.2%、73.0%，特异度为82.3%、80.0%，受试者操作特征曲线下面积为0.752、0.810，小腿围对应的最佳截断值为男性<34.5 cm、女性<33.5 cm。结论小腿围对社区慢性病共病老年患者肌少症的筛查更具灵敏度和准确性。

关键词: 肌少症, 指环测试, 小腿围, 筛查, 慢性病共病, 护理

Abstract:

Objective To compare the effect of the finger-ring test and the calf circumference on screening for sarcopenia in the elderly patients with multiple chronic conditions（MCCs）in the communities. Methods Convenience sampling method was used. From February to May 2022，330 elderly patients with MCCs in 15 communities in Zhengzhou City，Henan Province were selected and evaluated by finger-ring test and calf circumference respectively. Based on the diagnostic standard for sarcopenia proposed by Asian Working Group for Sarcopenia in 2019（AWGS 2019），we used SPSS26.0 software to calculate the sensitivity，specificity and predicted value. Receiver operating characteristic curve（ROC） was also drawn to calculate the area under curve（AUC）. Additionally，the optimal cut-of value for calf circumference screening tool was determined by calculating Youden index. Results Totally 320 elderly patients with MCCs were included；the incidence of sarcopenia was 20.63%；the incidences of sarcopenia obtained by the finger-ring test and calf circumference were 28.13% and 21.25%，respectively. The sensitivity of 2 screening tools in community sarcopenia were 68.2%，73.0%，while the specificity were 82.3%，80.0%. Additionally，the area under ROC were 0.752，0.810. The best cut-off for calf circumference was less than 34.5cm for men and less than 33.5cm for women. Conclusion Calf circumference is more sensitive and accurate in screening for sarcopenia in the elderly patients with MCCs in the community.

Key words: Sarcopenia, Finger-Ring Test, Calf Circumference, Screen, Multiple Chronic Conditions, Nursing Care

黄倩, 徐慧萍, 张艳, 刘延锦, 郭玉茹, 李慧景, 孙义芳, 时慕华, 王鑫. 社区慢性病共病老年患者肌少症筛查工具的比较研究[J]. 中华护理杂志, 2022, 57(24): 3017-3021.

HUANG Qian, XU Huiping, ZHANG Yan, LIU Yanjin, GUO Yuru, LI Huijing, SUN Yifang, SHI Muhua, WANG Xin. Comparative study of sarcopenia screening tools in community elderly patients with multiple chronic conditions[J]. Chinese Journal of Nursing, 2022, 57(24): 3017-3021.

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