维持性血液透析患者肌少症的发生机制、临床结局及干预策略研究进展

Research progress on the pathogenesis, clinical outcomes, and intervention strategies of sarcopenia in patients undergoing maintenance hemodialysis

摘要

维持性血液透析（MHD）患者中肌少症发生率较高，是影响患者功能状态、生活质量及长期预后的重要临床问题。肌少症以进行性、广泛性骨骼肌质量和功能丧失为特征，在 MHD 患者中常与慢性炎症、营养不良、代谢紊乱、内分泌异常及透析相关应激等多种因素共同作用，其发生机制复杂，进展较快，临床影响显著。鉴于肌少症在 MHD 人群中的高患病率及其不良临床结局，系统认识其发生机制、临床结局以及干预策略，对于临床早期识别高风险患者具有重要意义。文章围绕 MHD 患者肌少症的定义、流行病学特征、发生机制、临床结局及干预管理策略进行综述，以期加深对该人群肌少症临床意义的认识，为临床防治及后续研究提供参考。

Abstract

Sarcopenia is highly prevalent among patients undergoing maintenance hemodialysis (MHD) and represents an important clinical problem affecting functional status, quality of life, and long-term prognosis. Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and function. In MHD patients, it is often driven by the combined effects of multiple factors such as chronic inflammation, malnutrition, metabolic disorders, endocrine abnormalities, and dialysis-related stress. Its pathogenesis is complex, its progression is relatively rapid, and its clinical impact is substantial. Given the high prevalence of sarcopenia and its adverse clinical outcomes in the MHD population, a systematic understanding of its pathogenesis, clinical outcomes, and intervention strategies is of great significance for the early identification of high-risk patients in clinical practice. This article reviews the definition, epidemiological characteristics, pathogenesis, clinical outcomes, and intervention and management strategies of sarcopenia in MHD patients, with the aim of deepening the understanding of its clinical significance in this population and providing a reference for clinical prevention and treatment as well as future research.

关键词

维持性血液透析 / 肌少症 / 发生机制 / 临床结局 / 干预管理策略

Key words

Maintenance hemodialysis / Sarcopenia / Pathogenesis / Clinical outcomes / Intervention and management strategies

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基金资助

贵州省卫生健康委科学技术基金项目(gzwkj2021-137)