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中华重症医学电子杂志 ›› 2022, Vol. 08 ›› Issue (04) : 371 -377. doi: 10.3877/cma.j.issn.2096-1537.2022.04.016

综述

影像技术和分子生物标志物在重症患者骨骼肌质量评价中的应用
姚晏1, 黄惠斌1,()   
  1. 1. 102218 北京,清华大学临床医学院 清华大学附属北京清华长庚医院重症医学科
  • 收稿日期:2022-10-17 出版日期:2022-11-28
  • 通信作者: 黄惠斌
  • 基金资助:
    吴阶平医学基金会临床科研专项资助基金(320.6750.2022-02-18)

Assessment of muscle mass in critically ill patients: role of the molecular biomarkers and images studies

Yan Yao1, Huibin Huang1,()   

  1. 1. Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
  • Received:2022-10-17 Published:2022-11-28
  • Corresponding author: Huibin Huang
引用本文:

姚晏, 黄惠斌. 影像技术和分子生物标志物在重症患者骨骼肌质量评价中的应用[J/OL]. 中华重症医学电子杂志, 2022, 08(04): 371-377.

Yan Yao, Huibin Huang. Assessment of muscle mass in critically ill patients: role of the molecular biomarkers and images studies[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2022, 08(04): 371-377.

肌减少症在重症患者中非常普遍,并与ICU患者的不良结局相关。目前,采用人体测量法和血清蛋白等来确定骨骼肌肉质量是不可靠的。一些新技术,包括双能X线吸收仪、CT、超声波和生物阻抗分析,已被研究和验证用于ICU肌减少症的诊断和预后。然而,大多数重症患者往往无法获得这些技术。最近,尿素/肌酐和肌酐/胱抑素C构成了诊断肌减少症、预测ICU结果和评估危重患者营养状况的准确方法。本文对ICU患者骨骼肌质量评估进行综述,重点介绍适合在ICU患者中应用的相关影像学技术和血清学生物标志物的优点和局限性的相关证据。

Sarcopenia is common in critically ill patients and is associated with poor ICU outcomes. Anthropometric measurements and serum albumin are currently unreliable for determining muscle mass. Several new techniques for the diagnosis and prognosis of sarcopenia in the ICU, including dual-energy X-ray absorptiometry, computed tomography scanning, ultrasonography, and bioimpedance analysis, have been studied and validated. However, most critically ill patients do not have access to these techniques. Urea/creatinine and creatinine/cystatin C have recently been identified as an accurate method for diagnosing sarcopenia, predicting ICU outcomes, and assessing nutritional status in critically ill patients. This review of skeletal muscle quality assessment in ICU patients focuses on relevant evidence on the advantages and limitations of relevant imaging techniques and serological biomarkers suitable for application in ICU patients.

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