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危重症患者使用计算机断层扫描和生物电阻抗分析评估骨骼肌量的比较。

Comparative assessment of skeletal muscle mass using computerized tomography and bioelectrical impedance analysis in critically ill patients.

机构信息

Department of Acute Care Surgery, Korea Universith Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.

Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.

出版信息

Clin Nutr. 2019 Dec;38(6):2747-2755. doi: 10.1016/j.clnu.2018.12.002. Epub 2018 Dec 8.

Abstract

BACKGROUND

We compared the evaluation of skeletal muscle mass (SMM) using the computed tomography (CT) and bioelectrical impedance analysis (BIA) methods in critically ill patients. We also evaluated whether BIA can be applied for measuring SM with high accuracy to critically ill patients.

METHODS

We included 135 critically ill surgical patients (83 men and 52 women, mean age: 59.3 years) who got the BIA and abdominal CT scan both within 7 days during the intensive care unit (ICU) stay. With CT scan, skeletal muscle area (SMA) measured from the L3 spine level image was used for calculation of the whole body skeletal muscle volume and mass (kg). Body composition data from BIA were obtained using touch-type electrodes and 50 kHz current. Subgroup analyses for SMM were performed according to the sex, SMA, and edema status of the patients with Pearson correlation or regression analysis et al.

RESULTS

SMM from CT and BIA showed a good correlation (p < 0.0001) to sex, SMA, and edema in the subgroup analysis. A stronger correlation was noted between SMM from CT and BIA in male patients or mild edema group than for the other groups. SMM from BIA showed greater values than that from CT (mean difference, 3.35 kg) in all groups, except the normal SMA (higher than 170 cm in men, and 110 cm in women) group. Male patients and mild edema group showed more SMM as evaluated by BIA when compared to the other groups.

CONCLUSION

SMM measure by BIA in critically ill patients showed high correlation with SMM calculation by CT scan and had greater values than SMM from CT scan.

TRIAL REGISTRATION

Ajou University Hospital Institutional Review Board DEV-DE4-15-115, Registered Jan 1 2015.

摘要

背景

我们比较了使用计算机断层扫描(CT)和生物电阻抗分析(BIA)方法评估危重症患者骨骼肌量(SMM)的效果。我们还评估了 BIA 是否可以用于精确测量危重症患者的 SM。

方法

我们纳入了 135 名接受过 ICU 治疗的外科危重症患者(83 名男性和 52 名女性,平均年龄:59.3 岁),他们在 ICU 住院期间 7 天内都进行了 BIA 和腹部 CT 扫描。使用 CT 扫描,从 L3 脊柱水平图像测量骨骼肌面积(SMA),用于计算全身骨骼肌体积和质量(kg)。BIA 的身体成分数据是使用触敏电极和 50 kHz 电流获得的。根据患者的性别、SMA 和水肿状态进行 SMM 亚组分析,并进行 Pearson 相关或回归分析等。

结果

CT 和 BIA 得出的 SMM 与亚组分析中的性别、SMA 和水肿有很好的相关性(p<0.0001)。在男性患者或轻度水肿组中,CT 和 BIA 得出的 SMM 相关性更强,而在其他组中则较弱。在所有组中,除了 SMA 正常(男性高于 170cm,女性高于 110cm)的组之外,BIA 得出的 SMM 值均大于 CT 得出的 SMM 值(平均差值,3.35kg)。与其他组相比,BIA 得出的男性患者和轻度水肿组的 SMM 值更高。

结论

危重症患者 BIA 测量的 SMM 与 CT 扫描计算的 SMM 具有高度相关性,且其值大于 CT 扫描得出的 SMM 值。

试验注册

Ajou 大学医院机构审查委员会 DEV-DE4-15-115,于 2015 年 1 月 1 日注册。

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