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定量CT分析维持性血液透析患者体质成分

吕磊 翟建 李云成 赵亚子 刘艳

吕磊, 翟建, 李云成, 等. 定量CT分析维持性血液透析患者体质成分[J]. CT理论与应用研究, 2023, 32(2): 256-262. DOI: 10.15953/j.ctta.2022.050
引用本文: 吕磊, 翟建, 李云成, 等. 定量CT分析维持性血液透析患者体质成分[J]. CT理论与应用研究, 2023, 32(2): 256-262. DOI: 10.15953/j.ctta.2022.050
LV L, ZHAI J, LI Y C, et al. Quantitative CT Analysis of Body Composition in Maintenance Hemodialysis Patients[J]. CT Theory and Applications, 2023, 32(2): 256-262. DOI: 10.15953/j.ctta.2022.050. (in Chinese)
Citation: LV L, ZHAI J, LI Y C, et al. Quantitative CT Analysis of Body Composition in Maintenance Hemodialysis Patients[J]. CT Theory and Applications, 2023, 32(2): 256-262. DOI: 10.15953/j.ctta.2022.050. (in Chinese)

定量CT分析维持性血液透析患者体质成分

doi: 10.15953/j.ctta.2022.050
详细信息
    作者简介:

    吕磊:男,皖南医学院影像医学与核医学专硕研究生,主要从事CT及MRI诊断,E-mail:1416880062@qq.com

    翟建:男,皖南医学院弋矶山医院教授、主任医师、硕士研究生导师,主要从事颅脑MRI诊断及研究,E-mail:yjszhaij@126.com

    通讯作者:

    翟建*,男,皖南医学院弋矶山医院教授,主任医师,硕士研究生导师,主要从事颅脑MRI诊断及研究,E-mail:yjszhaij@126.com

  • 中图分类号: R  814

Quantitative CT Analysis of Body Composition in Maintenance Hemodialysis Patients

  • 摘要: 目的:分析维持性血液透析患者的体成分信息,探讨QCT技术的应用价值。方法:选取本院维持性血液透析患者共62例,根据不同的透析时长分为3组,运用定量CT技术测定患者的骨密度值、腹部脂肪及肌肉含量,同时选取性别及年龄相匹配的健康体检人群62例进行对比分析。结果:透析组骨质疏松者占17.70%(11例),骨量减少者占30.60%(19例),而在健康对照组中,骨质疏松及骨量减少者分别占6.50%(4例)和16.10%(10例),两组间的差异具有统计学意义;透析组的腹内脂肪和皮下脂肪含量分别为(113.70±63.29)cm2、(80.65±59.67)cm2,均低于健康对照组(135.90±58.80)cm2、(122.26±54.94)cm2,透析组L3-SMA<对照组 L3-SMA,(107.00±30.70)cm2<(121.37±32.87)cm2,均具有统计学差异;在不同性别透析患者中,男性透析患者的腰椎骨密度值为(156.11±51.94)(mg/cm3),与女性(124.29±50.89)(mg/cm3)比较,差异有统计学意义;女性患者的皮下脂肪含量要高于男性,而男性和女性的腹腔内脂肪含量差异无统计学意义;透析组的骨密度值和L3-SMA变化与透析时间长短无差异。结论:维持性血液透析患者的骨质疏松症发病率高于健康人群,腹部脂肪及肌肉含量低于健康人群,定量CT对体质成分监测的准确性和敏感性较高。

     

  • 图  1  QCT测量L3中心层面腹部脂肪

    绿色光圈外蓝色代表皮下脂肪含量,光圈内则代表腹腔内脂肪含量。

    Figure  1.  QCT measures abdominal fat at the center level of L3

    图  2  测量L1、L2椎体松质骨骨密度值

    Figure  2.  The measurement of the bone density values of the L1 and L2 vertebral bodies’ cancellous bone

    图  3  示意图,图中勾画的彩色区域即为L3-SMA

    Figure  3.  Schematic diagram of the L3-SMA (colored outlined area)

    图  4  实测图,绿色光圈内的区域面积相加即得到L3-SMA

    Figure  4.  In this measured diagram, the area of the region within the green aperture is added together and the L3-SMA is obtained

    表  1  健康人群与透析患者骨量状况比较

    Table  1.   Comparison of bone mass status between the healthy population and dialysis patients      

    组别骨量状况总计
    骨量正常骨量减少骨质疏松
    对照组48(77.40%)10(16.10%)4(6.5%)62(100%)
    透析组32(51.60%)19(30.60%)11(17.70%)62(100%)
    下载: 导出CSV

    表  2  健康人群与透析患者腹部脂肪及L3水平横断面肌肉面积比较($\bar x \pm s $

    Table  2.   Comparison of abdominal fat and L3-SMA between the healthy population and dialysis patients($\bar x \pm s $

    项目透析组对照组P
    腹内脂肪/cm2      113.70±63.29135.90±58.80<0.05
    皮下脂肪/cm2      80.65±59.67122.26±54.94<0.05
    L3水平横断面肌肉面积/cm2107.00±30.70121.37±32.87<0.05
    下载: 导出CSV

    表  3  不同性别血透患者骨密度及腹部脂肪比较($\bar x \pm s $

    Table  3.   Comparison of bone density and abdominal fat in hemodialysis patients of different sexes ($\bar x \pm s $

    组别骨密度/(mg/cm3腹内脂肪/cm2皮下脂肪/cm2
    男(n=33)156.11±51.94100.97±58.8163.47±54.02
    女(n=29)124.29±50.89128.18±66.07100.20±60.34
    P<0.05>0.05<0.05
    下载: 导出CSV

    表  4  透析患者骨密度及L3水平横断面肌肉面积与透析时间的变化规律($\bar x \pm s $

    Table  4.   Variation of bone density, L3-SMA, and dialysis time in dialysis patients ($\bar x \pm s $

    项目透析时间
    <2年(n=19)2~5年(n=23)>5年(n=20)
    骨密度/(mg/cm3)    132.17±52.21134.14±58.36157.99±47.10
    L3水平横断面肌肉面积/cm2115.91±42.16103.10±23.65103.03±24.07
    下载: 导出CSV
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出版历程
  • 收稿日期:  2022-03-22
  • 录用日期:  2022-06-25
  • 网络出版日期:  2022-06-30
  • 刊出日期:  2023-03-31

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