Journal of Surgery Concepts & Practice ›› 2020, Vol. 25 ›› Issue (02): 114-119.doi: 10.16139/j.1007-9610.2020.02.006
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SUN Jianqin(
), YE Mengyao
Received:2020-01-22
Online:2020-03-25
Published:2020-04-25
CLC Number:
SUN Jianqin, YE Mengyao. Screening, evaluation and intervention of sarcopenia in older people[J]. Journal of Surgery Concepts & Practice, 2020, 25(02): 114-119.
| 项目 | 切点制定及特点 | 诊断标准 | ||
|---|---|---|---|---|
| 指标 | 男性切点值 | 女性切点值 | ||
| Baumgartner诊断 标准（1998）[ | 基于Rosetta研究229名非西班牙裔白种年轻人（18~40岁）的数据制定参考切点：切点值设定为低于年轻参照组相应指标（均值-2SD） | ASM/身高2 (DXA) | <7.26 kg/m2 | <5.45 kg/m2 |
| EWGSOP1（2010）[ | 提出从肌量、肌力、肌肉功能等综合评估。建议以健康年轻人作为参考人群,以低于年轻参照组相应指标（均值-2SD）作为参考切点值。握力与步速参考切点值基于针对肌肉衰减症病人研究的数据 | 肌量减少临界值 | ||
| ASM/身高2 (DXA) | 年轻参照组相应指标 （平均值-2SD） | |||
| 肌力下降临界值 | ||||
| 握力 | <30 kg | <20 kg | ||
| 低体力活动临界值 | ||||
| 步速 | ≤0.8 m/s | |||
| IWGS（2011）[ | 基于EWGSOP1(2010)的诊断标准,弥补EWGSOP1(2010)缺少肌量具体参考切点的不足 | ASM/身高2 (DXA) | ≤7.23 kg/m2 | ≤5.67 kg/m2 |
| 步速 | <1 m/s | |||
| AWGS（2014）[ | 针对亚洲人群,综合多项亚洲人群研究结果,采用多项指标综合评估切点制定：使用低于年轻参照组相应指标的（均值-2SD）或低于年轻参照组相应指标的下五分位数为切点值;部分指标的切点值来自肌肉衰减症病人研究的数据 | 肌量减少临界值 | ||
| ASM/身高2（DXA） | <7.0 kg/m2 | <5.7 kg/m2 | ||
| 或ASM/身高2 （BIA） | <7.0 kg/m2 | <5.4 kg/m2 | ||
| 肌力下降临界值 | ||||
| 握力 | <26 kg | <18 kg | ||
| 低体力活动临界值 | ||||
| 步速 | ≤0.8 m/s | |||
| FNIH（2014）[ | 利用9项大型临床研究的数据（共26 625名参与者）制定切点,人群广泛多样;切点制定时强调体重对临界值的影响 | 肌力下降临界值 | ||
| 握力 | <26 kg | <16 kg | ||
| 或BMI校正的握力 | <1.0 | <0.56 | ||
| 肌量减少临界值 | ||||
| BMI校正的ASM | <0.789 | <0.512 | ||
| 或ASM (DXA) | <19.75 kg | <15.02 kg | ||
| 低体力活动临界值 | ||||
| 步速 | ≤0.8 m/s | |||
| EWGSOP2（2018）[ | 针对欧洲人群,切点制定仍沿用低于年轻参照组的相应指标（平均值-2SD）;部分特定情况下,建议使用（均值-2.5SD）。步速、握力等指标的切点值仍采用针对肌肉衰减症病人研究的数据 | 肌力下降临界值 | ||
| 握力 | <27 kg | <16 kg | ||
| 座椅起蹲试验 | 起蹲5次耗时>15 s | |||
| 肌量减少临界值 | ||||
| ASM (DXA) | <20 kg | <15 kg | ||
| ASM/身高2 (DXA) | <7.0 kg/m2 | <5.5 kg/m2 | ||
| 低体力活动临界值 | ||||
| 步速 | ≤0.8 m/s | |||
| SPPB | ≤8分 | |||
| TUG | ≥20 s | |||
| 400 m行走 | 未完成或≥6 min才完成 | |||
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