首页|肌肉减少症指标对70岁及以上食管癌患者术后肺炎的预测价值

肌肉减少症指标对70岁及以上食管癌患者术后肺炎的预测价值

扫码查看
目的 探讨术前肌肉减少症常用指标在预测70岁及以上食管癌患者术后肺炎发生中的临床应用价值.方法 回顾性分析2020年1月至2021年12月在我院行胸腹腔镜下食管癌根治术的398例≥70岁老年食管鳞癌患者的临床资料,分析临床病理相关指标以及肌肉减少症常用测量指标与术后肺炎发生的相关性.结果 ≥70岁食管鳞癌患者中术后发生肺炎的比例为27.9%(111/398);肺炎组患者术前测量的体质指数(BMI)及呼气峰值流量(PEF)指标均明显低于非肺炎组(t=2.799、2.674,均P<0.05);Logistic多因素分析显示,低PEF、低腰大肌指数(PMI)和低腰大肌密度(PMD)是≥70岁食管癌患者术后出现肺炎的主要危险因素(Wald x2=7.577、6.091、6.845,均P<0.05);低PEF、低PMI和低PMD的≥70岁食管癌患者术后发生肺炎的风险分别是高PEF、高PMI 和高 PMD 患者的 1.969 倍(95%CI:1.215~3.185,P=0.006)、1.912 倍(95%CI:1.143~3.205,P=0.014)和 1.832 倍(95%CI:1.164~2.882,P=0.009).结论 低 PEF、低 PMI 及低PMD是≥70岁食管癌患者术后发生肺炎的主要危险因素;术前PEF、PMI和PMD等肌肉减少症常用的测量指标可以作为术后肺炎发生的早期筛查指标.
The predictive value of sarcopenia index for postoperative pneumonia in ≥ 70 years old patients of esophageal cancer
Objective To investigate the clinical application value of commonly used preoperative indicators of sarcopenia in predicting postoperative pneumonia in patients aged 70 years and above with esophageal cancer.Methods A retrospective analysis was conducted on the clinical data of 398 elderly patients(≥70 years old)with esophageal squamous cell carcinoma who underwent thoracic laparoscopic radical resection of esophageal cancer in our hospital from January 2020 to December 2021.The study aimed to investigate the correlation between clinical pathological indicators and commonly used measurement indicators of sarcopenia and postoperative pneumonia.Statistical analysis was performed to analyze the data.Results The study found that the proportion of postoperative pneumonia in esophageal squamous cell carcinoma patients aged 70 years and above was 27.9%(111 out of 398).The pneumonia group had significantly lower preoperative BMI and peak expiratory flow(PEF)measurements compared to the non-pneumonia group,with statistically significant differences(t=2.799,2.674,both P<0.05).Logistic multivariate analysis revealed that low PEF,low psoas major muscle index(PMI),and low psoas muscle density(PMD)were the primary risk factors for postoperative pneumonia in esophageal cancer patients aged 70 years and above(Wald x2 values were 7.577,6.091,6.845,all P<0.05).The risk of postoperative pneumonia in esophageal cancer patients aged 70 years and above with low PEF,low PMI,and low PMD was found to be 1.969 times higher(95%CI:1.215-3.185,P=0.006),1.912 times higher(95%CI:1.143-3.205,P=0.014),and 1.832 times higher(95%CI:1.164-2.882,P=0.009)respectively,compared to patients with high PEF,high PMI,and high PMD.Conclusions Low PEF,low PMI,and low PMD are significant risk factors for postoperative pneumonia in esophageal cancer patients aged 70 years and older.Preoperative PEF,PMI,and PMD,which are commonly utilized measurement indicators for sarcopenia,can be utilized as early screening indicators for postoperative pneumonia.

Esophageal neoplosmasMuscular diseasesPneumoniaForecasting

陆鹏、尤振兵、张明志、徐克平、蒋超、刘金涛、田文泽

展开 >

南京医科大学附属淮安第一医院老年科,淮安 223300

南京医科大学附属淮安第一医院胸外科,淮安 223300

南京医科大学附属淮安第一医院肿瘤内科,淮安 223300

南京医科大学附属淮安第一医院医学影像科,淮安 223300

展开 >

食管肿瘤 肌疾病 肺炎 预测

淮安市自然科学基金研究项目江苏省医学重点学科建设单位项目国家自然科学基金青年基金

HAB202201JWDS20223382102969

2024

中华老年医学杂志
中华医学会

中华老年医学杂志

CSTPCD北大核心
影响因子:1.606
ISSN:0254-9026
年,卷(期):2024.43(1)
  • 19