切换至 "中华医学电子期刊资源库"
高级检索
中华关节外科杂志(电子版)

中华关节外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (01) : 30 -38. doi: 10.3877/cma.j.issn.1674-134X.2024.01.005

临床论著

膝骨关节炎患者的肌少症发病率及发病特点分析
姚放鸣1, 焦莹莹2, 何敏聪3,†(), 曾子俊1, 何晓铭4, 刘良燕5, 何伟4, 魏秋实6, 刘文刚7   
  1. 1. 510145　广州中医药大学第三临床医学院
    2. 510080　广州中医药大学科技创新中心
    3. 510095　广州，广东省中医药研究开发重点实验室；510145　广州中医药大学第三附属医院；510145　广州，广东省中医骨伤研究院
    4. 510145　广州中医药大学第三附属医院；510145　广州，广东省中医骨伤研究院
    5. 515400　揭阳，揭西县中医医院博士工作站
    6. 510095　广州，广东省中医药研究开发重点实验室；510145　广州中医药大学第三附属医院；510145　广州，广东省中医骨伤研究院；515400　揭阳，揭西县中医医院博士工作站
    7. 510095　广州，广东省中医药研究开发重点实验室；510030　广州，广东省第二中医院（广东省中医药工程技术研究院）
  • 收稿日期:2023-10-31 出版日期:2024-02-01
  • 通信作者: 何敏聪
  • 基金资助:
    广东省中医药研究开发重点实验室开放基金资助课题(KFKT01-003); 广东省中医药局中医药科研项目（科研平台专项）(20233002); 广东省中医骨伤研究院开放课题基金项目(GYH202201-01); 广东省中医药局科研项目(20211209)

Incidence and analysis of characteristics of sarcopenia in patients with knee osteoarthritis

Fangming Yao1, Yingying Jiao2, Mincong He3,†(), Zijun Zeng1, Xiaoming He4, Liangyan Liu5, Wei He4, Qiushi Wei6, Wengang Liu7   

  1. 1. The Third Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510145, China
    2. Science and Technology Innovation Center of Guangzhou University of Chinese Medicine, Guangzhou 510080, China
    3. Guangdong Provincial Key Laboratory of Research and Development in Traditional Chinese Medicine, Guangzhou 510095, China; The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510145, China; Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, Guangzhou 510145, China
    4. The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510145, China; Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, Guangzhou 510145, China
    5. Doctoral Workstation of Jiexi County Chinese Medicine Hospital, Jieyang 515400, China
    6. Guangdong Provincial Key Laboratory of Research and Development in Traditional Chinese Medicine, Guangzhou 510095, China; The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510145, China; Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, Guangzhou 510145, China; Doctoral Workstation of Jiexi County Chinese Medicine Hospital, Jieyang 515400, China
    7. Guangdong Provincial Key Laboratory of Research and Development in Traditional Chinese Medicine, Guangzhou 510095, China; Guangdong Second Traditional Chinese Medicine Hospital (Guangdong Research Institute of Traditional Chinese Medicine Manuracturing Technology), Guangzhou 510030, China
  • Received:2023-10-31 Published:2024-02-01
  • Corresponding author: Mincong He
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

姚放鸣, 焦莹莹, 何敏聪, 曾子俊, 何晓铭, 刘良燕, 何伟, 魏秋实, 刘文刚. 膝骨关节炎患者的肌少症发病率及发病特点分析[J]. 中华关节外科杂志(电子版), 2024, 18(01): 30-38.

Fangming Yao, Yingying Jiao, Mincong He, Zijun Zeng, Xiaoming He, Liangyan Liu, Wei He, Qiushi Wei, Wengang Liu. Incidence and analysis of characteristics of sarcopenia in patients with knee osteoarthritis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(01): 30-38.

目的

本研究拟分析膝骨关节炎(KOA)患者群体中的肌少症(SP)发病率以及发病特点，分析两种疾病的共同发病特征。

方法

按纳入排除标准共收集2022年11月至2023年7月于广州中医药大学第三附属医院关节中心住院治疗的KOA患者共129例(215侧下肢)。纳入标准：近1个月内膝关节疼痛，年龄≥50岁，晨僵时间≤30 min，X线片提示膝关节间隙变窄、软骨下骨硬化和/或囊性变、骨赘形成；排除标准：诊断为其他类型关节炎，合并有影响下肢肢体功能的其他疾病，无法配合数据收集。提取一般资料[性别、年龄、身高、体重、身体质量指数(BMI)]，及四肢骨骼肌质量指数(ASMI)、髋膝踝角(HKA)、关节线夹角(JLCA)、膝关节内侧关节间隙宽度(MJSW)、外侧关节间隙宽度(LJSW)等相关数据。按照亚洲肌少症工作组提出的肌少症诊断将患者分为肌少症－膝骨关节炎(SP-KOA)组和膝骨关节炎(KOA)组，采用秩和检验、独立样本t检验、卡方检验等对不同数据类型的资料进行组间分析。根据logistic回归分析KOA患者患SP的危险因素，采用R语言根据logistic回归筛选的影响因素构建评估KOA患者的SP患病风险的列线图模型，并评估模型区分度与准确度。

结果

129例KOA患者中合并SP者共28例，SP患病率为21.7%。总样本分析显示SP-KOA组下肢力线状况更好(Z＝2.901，P<0.05)，KOA严重程度更轻(χ2＝10.290，P<0.05)，同时BMI更低(Z＝7.175, P<0.05)，男性比例更高(χ2＝7.224，P<0.05)。二元logistic回归分析提示男性KOA患者的BMI [比值比(OR)＝0.254，95%置信区间(CI)(0.087，0.747)]，以及女性KOA患者的BMI [OR＝0.782, 95%CI(0.679，0.899)]、LJSW [OR＝0.596, 95%CI(0.396，0.897)]、年龄[OR＝1.066, 95%CI(1.003，1.132)]对SP发病的影响有统计学意义(均为P<0.05)。

结论

本研究表明在KOA患者中，男性KOA患者、BMI偏低的患者可能更易合并SP，这提示在膝骨关节炎早期应提倡患者均衡膳食，纠正体重偏低，同时进行非负重性锻炼，提升骨骼肌质量与肌力，减少SP患病风险。

关键词: 肌减少症, 骨关节炎，膝, 横断面研究, 危险因素, 列线图
Objective

To analyze the incidence and characteristics of sarcopenia (SP) in the population of knee osteoarthritis (KOA) patients and explore common features between the two conditions.

Methods

A total of 129 KOA patients (215 lower limbs) treated at the Joint Center of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from November 2022 to July 2023 were included based on specific criteria. Inclusion criteria: knee joint pain within the past month, age≥50 years, morning stiffness≤30 min, and X-ray evidence of narrowed knee joint space, subchondral bone sclerosis, and/or cystic changes, and osteophyte formation. Exclusion criteria: other types of arthritis, concurrent lower limb impairing conditions, and inability to cooperate with data collection. General information [gender, age, height, weight, body mass index (BMI)], and relevant data such as appendicular skeletal muscle mass index (ASMI), hip-knee-ankle angle (HKA), joint line convergence angle (JLCA), medial joint space width (MJSW), and lateral joint space width (LJSW) were collected. According to the criteria proposed by the Asian Working Group for Sarcopenia, patients were categorized into the SP-KOA group and KOA group. Group analysis was conducted using rank-sum tests, independent sample t tests, and chi-square tests. Logistic regression analysis was performed to identify risk factors for SP in KOA patients. A nomogram model was constructed using R language based on logistic regression-selected influencing factors, and the model's discriminative ability and accuracy were assessed.

Results

Among the 129 KOA patients, 28 had concomitant SP, resulting in a sarcopenia incidence rate of 21.7%. The overall analysis showed that the lower limb alignment was better in the SP-KOA group (Z=2.901, P<0.05), KOA severity was milder (χ2=10.290, P<0.05), BMI was lower (Z=7.175, P<0.05), and the proportion of males was higher (χ2=7.224, P<0.05). Binary logistic regression analysis indicated that BMI in male KOA patients [odds ratio (OR)=0.254, 95% confidence interval (CI) (0.087, 0.747)], and in female KOA patients BMI [OR=0.782, 95%CI (0.679, 0.899)], LJSW [OR=0.596, 95%CI (0.396, 0.897)], and age [OR=1.066, 95%CI (1.003, 1.132)] had statistically significant impacts on the incidence of SP (all P<0.05).

Conclusions

This study suggests that among KOA patients, male KOA patients and those with lower BMI may be more prone to concomitant SP. This emphasizes the importance of promoting a balanced diet, correcting low body weight, and engaging in non-weight-bearing exercises in the early stages of knee osteoarthritis to improve skeletal muscle mass, strength, and reduce the risk of developing sarcopenia.

Key words: Sarcopenia, Osteoarthritis, knee, Cross-sectional studies, Risk factors, Nomograms
图1 SP(肌少症)-KOA(膝骨关节炎)组与KOA组基线信息及影像学参数对比。图A为年龄组间对比(Z＝1.917)；图B为性别组间对比(χ2＝7.224)；图C为身高组间对比(Z＝1.874)；图D为体重组间对比(t＝7.122)；图E为BMI组间对比(Z＝7.175)；图F为HKA组间对比(Z＝2.901)；图G为JLCA组间对比(Z＝3.664)；图H为MJSW组间对比(Z＝2.215)；图I为LJSW组间对比(Z＝4.036)；图J为KL分级组间对比(χ2＝10.290)注：*-P<0.05；**-P<0.01；ns-无意义；HKA-髋膝踝角；JLCA-关节线夹角；MJSW-内侧间隙宽度；LJSW-外侧间隙宽度；BMI-身体质量指数；KL-Kellgren & Lawrence分级
Figure 1 Comparison of baseline information and radiographic parameters between the SP-KOA group and the KOA group. A is age comparison(Z＝1.917); B is gender comparison(χ2＝7.224); C is height comparison(Z＝1.874); D is body weight comparison (t＝7.122); E is BMI comparison(Z＝7.175); F is HKA comparison(Z＝2.901); G is JLCA comparison(Z＝3.664); H is MJSW comparison(Z＝2.215); I is LJSW comparison(Z＝4.036); J is K-L grading comparison(χ2＝10.290) Note：*-P<0.05；**-P<0.01；ns-meaningless；HKA-hip-knee-ankle angle；JLCA-joint line convergence angle；MJSW-medial joint space width；LJSW-lateral joint space width；BMI-body mass index；KL-Kellgren & Lawrence grade
图2 轻度与重度KOA(膝骨关节炎)患者BMI(身体质量指数)组间分析注：*-χ2＝10.290, P<0.05
Figure 2 Group analysis of BMI between mild and severe KOA patients
表1 KOA患者SP患病危险因素的二元logistic回归分析
Table 1 Logistic regression analysis on risk factors for SP disease in KOA patients
因素Factors 赋值Assign B值 SE Wald值 OR 95%CI P值
HKA 连续变量 0.110 0.063 3.058 1.116 (0.987，1.262) 0.080
JLCA 连续变量 0.188 0.176 1.149 1.207 (0.855，1.704) 0.284
MJSW 连续变量 －0.067 0.223 0.090 0.935 (0.604，1.449) 0.765
LJSW 连续变量 －0.381 0.206 3.408 0.683 (0.456，1.024) 0.065
KL分级 "1－2级"＝0，"3－4级"＝1 －0.355 0.634 0.313 0.701 (0.202，2.430) 0.576
性别 "男"＝0，"女"＝1 －1.642 0.501 10.722 0.194 (0.072，0.517) 0.001
BMI 连续变量 －0.363 0.070 27.244 0.695 (0.607，0.797) <0.001
常量   －8.720 11.038 0.624 <0.001   0.430
图3 男性KOA(膝骨关节炎)患者SP(肌少症)-KOA亚组与KOA亚组基线信息及影像学参数对比。图A为年龄组间对比(t＝1.040)；图B为身高组间对比(Z＝0.271)；图C体重为组间对比(Z＝5.285)；图D为BMI组间对比(Z＝5.272)；图E为HKA组间对比(t＝－2.832)；图F为JLCA组间对比(t＝3.390)；图G为MJSW组间对比(Z＝2.817)；图H为LJSW组间对比(Z＝1.208)；图I为KL组间对比(χ2＝10.581)注：M-男性；*-P<0.05；**-P<0.01；ns-无意义；HKA-髋膝踝角；JLCA-关节线夹角；MJSW-内侧间隙宽度；LJSW-外侧间隙宽度；BMI-身体质量指数；KL-Kellgren & Lawrence分级
Figure 3 Comparison of baseline information and radiographic parameters between the SP-KOA subgroup and the KOA subgroup of male KOA patients. A is age comparison(t＝1.040); B is height comparison(Z＝0.271); C is body weight comparison(Z＝5.285); D is BMI comparison(Z＝5.272); E is HKA comparison(t＝－2.832); F is JLCA comparison(t＝3.390); G is MJSW comparison(Z＝2.817); H is LJSW comparison(Z＝1.208); I is K-L grading comparison(χ2＝10.581) Note: M-male；*-P<0.05；**-P<0.01；ns-meaningless；HKA-hip-knee-ankle angle；JLCA-joint line convergence angle；MJSW-medial joint space width；LJSW-lateral joint space width；BMI-body mass index；KL-Kellgren & Lawrence grade
表2 男性KOA患者SP患病危险因素的logistic回归分析
Table 2 Logistic regression analysis of risk factors for SP in male KOA patients
因素Factors 赋值Assign B值 SE Wald值 OR 95%CI P值
HKA 连续变量 0.352 0.319 1.216 1.421 (0.761，2.656) 0.270
JLCA 连续变量 0.132 0.470 0.079 1.141 (0.454，2.868) 0.779
MJSW 连续变量 0.253 0.872 0.084 1.288 (0.233，7.115) 0.772
KL分级 "1－2级"＝0，"3－4级"＝1 3.546 2.139 2.748 34.665 (0.524，2 293.009) 0.097
BMI 连续变量 －1.369 0.550 6.204 0.254 (0.087，0.747) 0.013
常量   －31.446 52.741 0.355 <0.001   0.551
图4 女性(膝骨关节炎)患者SP(肌少症)-KOA亚组与KOA亚组基线信息及影像学参数对比。图A为年龄组间对比(Z＝－2.518)；图B为身高组间对比(Z＝－0.040)；图C体重为组间对比(t＝4.411)；图D为BMI组间对比(t＝6.786)；图E为HKA组间对比(Z＝－2.180)；图F为JLCA组间对比(Z＝－1.948)；图G为MJSW组间对比(Z＝－0.530)；图H为LJSW组间对比(Z＝3.834)；图I为KL组间对比(χ2＝3.441)注：F-女性；*-P<0.05；**-P<0.01；ns-无意义；HKA-髋膝踝角；JLCA-关节线夹角；MJSW-内侧间隙宽度；LJSW-外侧间隙宽度；BMI-身体质量指数；KL-Kellgren &Lawrence分级
Figure 4 Comparison of baseline information and radiographic parameters between the SP-KOA subgroup and the KOA subgroup of female KOA patients. A is age comparison(Z＝－2.518); B is height comparison(Z＝－0.040); C is body weight comparison(t＝4.411); D is BMI comparison(t＝6.786); E is HKA comparison(Z＝－2.180); F is JLCA comparison(Z＝－1.948); G is MJSW comparison(Z＝－0.530); H is LJSW comparison(Z＝3.834); I is K-L grading comparison(χ2＝3.441) Note: F-Female；*-P<0.05；**-P<0.01；ns-meaningless；HKA-hip-knee-ankle angle；JLCA-joint line convergence angle；MJSW-medial joint space width；LJSW-lateral joint space width；BMI-body mass index；KL-Kellgren &Lawrence grades
表3 女性KOA患者SP患病风险的二元logistic回归分析结果
Table 3 Logistic regression analysis of risk factors for SP in female KOA patients
因素Factors 赋值Assign B值 SE Wald值 OR 95%CI P值
HKA 连续变量 0.033 0.054 0.362 1.033 (0.929，1.149) 0.547
LJSW 连续变量 －0.518 0.209 6.164 0.596 (0.396，0.897) 0.013
年龄 连续变量 0.064 0.031 4.276 1.066 (1.003，1.132) 0.039
KL分级 "1－2级"＝0，"3－4级"＝1 －0.188 0.555 0.114 0.829 (0.279，2.460) 0.735
BMI 连续变量 －0.246 0.072 11.846 0.782 (0.679，0.899) 0.001
常量   －2.900 10.414 0.078 0.055   0.781
图5 女性KOA(膝骨关节炎)患者SP(肌少症)患病风险预测模型构建。图A为女性KOA患者发生SP的风险预测模型；图B为列线图模型的校准曲线分析；图C为女性KOA患者SP患病率的ROC曲线注：KOA-膝骨关节炎；SP-肌少症；LJSW-外侧间隙宽度；Age-年龄；BMI-身体质量指数；Actual probability-实际概率；Nomogram predicted probability-列线图预测概率
Figure 5 Construction of a nomogram model of risk factors for SP in female KOA patients. A is risk prediction model of SP in female KOA patients; B is calibration curve analysis of nomogram model; C is ROC of SP incidence in female KOA patients Note: KOA-knee osteoarthritis；SP-sarcopenia；LJSW-lateral joint space width；BMI-body mass index
[1]
Michael JWP, Schlüter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee[J]. DtschArzteblInt, 2010, 107(9): 152－162.
[2]
Litwic A, Edwards MH, Dennison EM, et al. Epidemiology and burden of osteoarthritis[J]. Br Med Bull, 2013, 105: 185－199.
[3]
Cho MR, Lee S, Song SK. A review of sarcopenia pathophysiology, diagnosis, treatment and future direction[J/OL]. J Korean Med Sci, 2022, 37(18): e146. DOI: 10.3346/jkms.2022.37.e146.
[4]
Dhillon RJS, Hasni S. Pathogenesis and management of sarcopenia[J]. Clin Geriatr Med, 2017, 33(1): 17－26.
[5]
Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia[J]. Jam Med Dir Assoc, 2014, 15(2): 95－101.
[6]
Kohn MD, Sassoon AA, Fernando ND. Classifications in brief: kellgren-lawrence classification of osteoarthritis[J]. Clin Orthop Relat Res, 2016, 474(8): 1886－1893.
[7]
Sekiya I, Sasaki S, Miura Y, et al. Medial tibial osteophyte width strongly reflects medial Meniscusextrusion distance and medial joint space width moderately reflects cartilage thickness in knee radiographs[J]. J Magn Reson Imaging, 2022, 56(3): 824－834.
[8]
黄宏兴，史晓林，李盛华，等. 肌少－骨质疏松症专家共识[J]. 中国骨质疏松杂志，2022, 28(11): 1561－1570.
[9]
Clynes MA, Gregson CL, Bruyère O, et al. Osteosarcopenia: where osteoporosis and sarcopenia collide[J]. Rheumatology, 2021, 60(2): 529－537.
[10]
Pegreffi F, Balestra A, De Lucia O, et al. Prevalence of sarcopenia in knee osteoarthritis: asystematic review and meta-analysis[J/OL]. J Clin Med, 2023, 12(4): 1532. DOI: 10.3390/jcm12041532.
[11]
Kim HI, Ahn SH, Kim Y, et al. Effects of sarcopenia and sarcopenic obesity on joint pain and degenerative osteoarthritis in postmenopausal women[J/OL]. Sci Rep, 2022, 12(1): 13543. DOI: 10.1038/s41598-022-17451-1.
[12]
Zhang L, Zhang C, Zhang J, et al. A bidirectional Mendelian randomization study of sarcopenia-related traits and knee osteoarthritis[J]. Clin Interv Aging, 2023, 18: 1577－1586.
[13]
Liao CD, Chen HC, Liou TH, et al. Impact of sarcopenia and obesity on gait speed after total knee replacement[J]. J Am Med Dir Assoc, 2022, 23(4): 631－637.
[14]
Park HM, Kim HJ, Lee B, et al. Decreased muscle mass is independently associated with knee pain in female patients with radiographically mild osteoarthritis: a nationwide cross-sectional study (KNHANES 2010-2011)[J]. Clin Rheumatol, 2018, 37(5): 1333－1340.
[15]
Misra D, Fielding RA, Felson DT, et al. Risk of knee osteoarthritis with obesity, sarcopenic obesity, and sarcopenia[J]. Arthritis Rheumatol, 2019, 71(2): 232－237.
[16]
Veronese N, Stefanac S, Koyanagi A, et al. Lower limb muscle strength and muscle mass are associated with incident symptomatic knee osteoarthritis: alongitudinal cohort study[J/OL]. Front Endocrinol, 2021, 12: 804560. DOI: 10.3389/fendo.2021.804560.
[17]
Petermann-Rocha F, Balntzi V, Gray SR, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis[J]. J Cachexia Sarcopenia Muscle, 2022, 13(1): 86－99.
[18]
Zengin A, Kulkarni B, Khadilkar AV, et al. Prevalence of sarcopenia and relationships between muscle and bone in Indian men and women[J]. Calcif Tissue Int, 2021, 109(4): 423－433.
[19]
Du Y, Wang X, Xie H, et al. Sex differences in the prevalence and adverse outcomes of sarcopenia and sarcopenic obesity in community dwelling elderly in East China using the AWGS criteria[J/OL]. BMC Endocr Disord, 2019, 19(1): 109. DOI: 10.1186/s12902-019-0432-x.
[20]
Sharma L. Osteoarthritis of the Knee[J]. N Engl J Med, 2021, 384(1): 51－59.
[21]
Choi KM. Sarcopenia and sarcopenic obesity[J]. Korean J Intern Med, 2016, 31(6): 1054－1060.
[22]
Batsis JA, Villareal DT. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies[J]. Nat Rev Endocrinol, 2018, 14(9): 513－537.
[23]
Elagizi A, Kachur S, LavieCJ, et al. An overview and update on obesity and the obesity paradox in cardiovascular diseases[J]. Prog Cardiovasc Dis, 2018, 61(2): 142－150.
[24]
Furtado EVH, Alves JJDA, Santos EJF, et al. Sarcopenia and inflammation in patients undergoing hemodialysis[J/OL]. Nutrición Hospitalaria, 2020[2023－10－23]. DOI：10.20960/nh.03068.

URL    
[25]
Merchant RA, Seetharaman S, Au L, et al. Relationship of fat mass index and fat free mass index with body mass index and association with function, cognition and sarcopenia in pre-frail older adults[J/OL]. Front Endocrinol, 2021, 12: 765415. DOI: 10.3389/fendo.2021.765415.
[26]
Wu LC, Kao HH, Chen HJ, et al. Preliminary screening for sarcopenia and related risk factors among the elderly[J/OL]. Medicine, 2021, 100(19): e25946. DOI: 10.1097/MD.0000000000025946.
[27]
Kim HJ, Hong YH. Age-related low skeletal muscle mass correlates with joint space narrowing in knee osteoarthritis in a South Korean population: a cross-sectional, case-control study[J]. J Yeungnam Med Sci, 2022, 39(4): 285－293.
[1] 王晓梅, 刘冰, 马丽琼, 卢祖静, 苗建军. 基于LASSO-Cox回归分析的非轻症急性胰腺炎死亡风险列线图预测模型的建立和临床应用效果分析[J]. 中华普通外科学文献(电子版), 2024, 18(01): 44-50.
[2] 吴方园, 孙霞, 林昌锋, 张震生. HBV相关肝硬化合并急性上消化道出血的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 45-47.
[3] 甄子铂, 刘金虎. 基于列线图模型探究静脉全身麻醉腹腔镜胆囊切除术患者术后肠道功能紊乱的影响因素[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 61-65.
[4] 陈旭渊, 罗仕云, 李文忠, 李毅. 腺源性肛瘘经手术治疗后创面愈合困难的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 82-85.
[5] 唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[6] 刘化胜, 郑龙波, 秦琛, 王伟芹, 郑学风, 马金龙, 马正, 王洪霞, 刘磊, 胡继霖. 基于影像学指标构建永久性乙状结肠造口旁疝发病风险预测模型[J]. 中华疝和腹壁外科杂志(电子版), 2024, 18(01): 75-82.
[7] 师帅, 马文星, 陈昕, 单良, 王泽正, 段降龙, 吴云桦. 腹壁切口疝围手术期并发症发生危险因素分析[J]. 中华疝和腹壁外科杂志(电子版), 2024, 18(01): 83-88.
[8] 孙振, 谭天华, 郑洋洋, 李喆, 宋京海. 基于术前纤维蛋白原与白蛋白比值构建肝癌微血管侵犯的预测模型[J]. 中华肝脏外科手术学电子杂志, 2024, 13(01): 27-32.
[9] 王明, 杨程凯, 吴小雅, 沈佳佳, 黄兴华, 吕立志, 蔡秋程, 杨芳, 刘建勇, 江艺. 逆灌注法DCD供肝对肝移植术后早期肝功能恢复的影响及危险因素分析[J]. 中华肝脏外科手术学电子杂志, 2024, 13(01): 33-38.
[10] 苏日顺, 卢逸, 庄宝鼎, 张译, 李彦杰, 徐见亮. 肝硬化脾亢脾切除术后门静脉血栓形成影响因素[J]. 中华肝脏外科手术学电子杂志, 2024, 13(01): 39-44.
[11] 潘晓帆, 徐勤义, 陆瑨, 王丹, 刘路路, 董万利. 颅内动脉瘤破裂介入术后并发脑疝的风险因素分析[J]. 中华脑科疾病与康复杂志(电子版), 2024, 14(01): 37-44.
[12] 李益军, 梁兴森, 方细霞, 肖文良, 李湘, 高彦平, 李嘉, 李玲. 温针灸治疗早中期寒湿痹阻型膝骨关节炎的疗效观察[J]. 中华针灸电子杂志, 2024, 13(01): 7-12.
[13] 薛伟, 康少英, 郭洪生, 高庆亮, 张英民, 高彦平. 电针联合富血小板血浆治疗膝骨关节炎的疗效观察[J]. 中华针灸电子杂志, 2024, 13(01): 13-17.
[14] 王林源, 熊鑫, 杨坤, 邓勇志. 基于冠状动脉CT血管成像的影像组学列线图鉴别诊断易损斑块的价值[J]. 中华诊断学电子杂志, 2024, 12(01): 1-8.
[15] 吴敬芳, 谭清实, 郗夏颖, 樊节敏, 韩蕾, 辛美云. 鲁西南地区儿童呼吸道合胞病毒肺炎临床特征分析[J]. 中华诊断学电子杂志, 2024, 12(01): 44-49.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号