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COVID-19 患者的胸部 CT 衍生肌肉分析。

Chest CT-Derived Muscle Analysis in COVID-19 Patients.

机构信息

Azienda Sanitaria Locale Lanciano, 66100 Vasto, Italy.

Department of Radiology, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", 60126 Ancona, Italy.

出版信息

Tomography. 2022 Feb 8;8(1):414-422. doi: 10.3390/tomography8010034.

Abstract

sarcopenia is a predictor of unfavorable outcomes, but its prognostic impact on patients with COVID-19 is not well known. To evaluate the association between the chest computed tomography (CT) derived muscle analysis of sarcopenia and clinical-radiological outcomes in coronavirus disease 2019 (COVID-19). in this retrospective study were revised the medical records of patients admitted to the intensive care unit (ICU) and intubated for COVID-19. All patients had undergone chest CT scan prior to intubation, and the cross-sectional areas of the pectoralis muscles (PMA, cm) and density (PMD, HU) were measured at the level of the fourth thoracic vertebral. The relationship between PMA and PMD and CT severity pneumonia, length of ICU, extubation failure/success, and mortality were investigated. a total of 112 patients were included (82 M; mean age 60.5 ± 11.4 years). Patients with successful extubation had higher PMA compared to patients with failure extubation, 42.1 ± 7.9 vs. 37.8 ± 6.4 cm ( = 0.0056) and patients with shorter ICU had higher PMA and PMD compared to those with longer, respectively, 41.6 ± 8.7 vs. 37.2 ± 6.7 cm ( = 0.0034) and 30.2 ± 6.2 vs. 26.1 ± 4.9 HU ( = 0.0002). No statistical difference in PMA and PMD resulted in CT severity pneumonia and mortality. sarcopenia in COVID-19 patients, evaluated by CT-derived muscle analysis, could be associated with longer ICU stay and failure extubation.

摘要

肌肉减少症是预后不良的预测因素,但它对 COVID-19 患者的预后影响尚不清楚。评估 2019 年冠状病毒病(COVID-19)中胸部计算机断层扫描(CT)得出的肌肉分析与临床影像学结果之间的关系。在这项回顾性研究中,我们修订了因 COVID-19 入住重症监护病房(ICU)并插管的患者的病历。所有患者在插管前均进行了胸部 CT 扫描,并在第四胸椎水平测量了胸大肌的横截面积(PMA,cm)和密度(PMD,HU)。研究了 PMA 和 PMD 与 CT 严重肺炎、ICU 时间、拔管失败/成功和死亡率之间的关系。共纳入 112 例患者(82 例男性;平均年龄 60.5 ± 11.4 岁)。与拔管失败的患者相比,拔管成功的患者的 PMA 更高,分别为 42.1 ± 7.9cm 和 37.8 ± 6.4cm( = 0.0056),与 ICU 时间较长的患者相比,ICU 时间较短的患者的 PMA 和 PMD 更高,分别为 41.6 ± 8.7cm 和 37.2 ± 6.7cm( = 0.0034)和 30.2 ± 6.2 HU 和 26.1 ± 4.9 HU( = 0.0002)。在 PMA 和 PMD 方面,CT 严重肺炎和死亡率无统计学差异。通过 CT 衍生的肌肉分析评估的 COVID-19 患者的肌肉减少症可能与 ICU 时间延长和拔管失败有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d7b/8878548/40ba1f29933c/tomography-08-00034-g001.jpg

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