基于机会性计算机断层扫描的萨尔科佩尼亚查和肝移植后的死亡率:系统性审查和元分析
Daniel Alvarenga Fernandes1, Daniel Bohn2, Pedro Antune da Silva Pereira3
1Universidade Estadual de Campinas, School of Medical Sciences, Department of Anesthesiology, Oncology, and Radiology - Campinas (SP), Brazil.
概括
麻症或肌肉质量损失,通过使用Psoas肌肉指数的计算机断层扫描来诊断,在肝移植后,死亡风险明显增加了四倍以上. 早期识别对于优化患者的治疗结果至关重要.
科学领域:
- 肝病学和移植外科手术
- 放射学和医学成像学 医学成像学
- 老年病学和老年学.
背景情况:
- 在患有慢性肝病 (CLD) 的患者中,萨科佩尼亚是一个重大问题.
- 准确的手术前评估是对预测肝移植后的结果至关重要的.
- 计算机断层扫描 (CT) 查提供了一种机会性方法来评估肌肉质量.
研究的目的:
- 通过机会性CT查CLD患者的萨尔科佩尼亚来研究Psoas肌肉指数 (PMI) 的诊断效用.
- 评估PMI作为肝移植后死亡率的预测指标.
- 评估CT诊断的肉类症与移植后生存率之间的关联.
主要方法:
- 在PubMed,Scopus和Cochrane控制试验中央注册表 (2014年7月至2024年7月) 进行了系统的文献搜索.
- 纳入标准侧重于观察性研究和临床试验,涉及成年CLD患者,通过CT诊断出肉症,正在接受或等待肝移植.
- 对包括382名患者在内的四项选定的研究进行了元分析.
主要成果:
- 通过CT扫描和PMI识别的形患者,肝移植后死亡风险高4.1倍 (OR 4.1386; p<0.0001).
- 分析表明,包括的研究中异质性很低,这支持了研究结果的稳定性.
- 脊髓肌肉指数被证明是增加死亡风险的可靠指标.
结论:
- 通过机会性CT扫描使用Psoas肌肉指数诊断的肌肉质量损失与肝移植后的死亡风险显著增加有关.
- 在手术前识别 sarcopenic 患者对于改善肝移植结果至关重要.
- 在等待移植的CLD患者中,PMI方法为机会性肉症查提供了一种实用的方法.
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