【摘要】 目的 探讨老年冠心病合并肌少症与血清肌酐及胱抑素C比值的相关性。方法 选取2020年12月至2021年11月于内蒙古自治区人民医院老年医学中心、心内科住院及体检中心的老年冠心病患者，根据是否患有肌少症分为冠心病肌少症组，冠心病非肌少症组。结果 (1)老年冠心病肌少症组的平均年龄大于非肌少症组，差异有显著统计学意义(P=0.006);在≥60岁的老年患者中随着年龄的增加，肌少症的发生增加；(2)老年冠心病肌少症组中男性多于女性，差异有显著统计学意义(P<0.01);(3)老年冠心病肌少症中握力及左右腿、左右臂肌肉量、四肢肌肉量、骨骼肌质量指数均低于非肌少症组，差异具有显著统计学意义(P<0.01);(4)老年冠心病肌少症组中BMI、HDL-C、Cr均低于非肌少症组，差异具有统计学意义(P<0.05);TG、TC、Cys C均高于非肌少症组，差异有统计学意义(P<0.05);(5)老年冠心病肌少症组Cr/Cys C比值低于非肌少症组，差异有显著统计学意义(P<0.01);(6)Logistic回归分析结果显示，在性别、年龄、BMI、TG、TC、HDL-C、Cr/Cys-C等诸多因素中，性别(OR=16.267,95%Cl 5.550-47.677,P<0.01)、年龄(OR=1.063,95%Cl 1.018～1.111,P=0.006)、BMI(OR=0.879,95%Cl 0.777-0.996,P=0.042)、Cr/Cys C(OR=0.489,95%Cl 0.357～0.671,P<0.01)是老年冠心病合并肌少症的相关危险因素；(7)ROC曲线分析得出Cr/Cys C比值的敏感度为94%,特异度为65%,约登指数为0.594,阈值为0.7,曲线下面积(AUC)为0.766。当Cr/Cys C比值<0.7时，老年冠心病有合并肌少症的可能。结论 年龄、性别、BMI、Cr/Cys C比值是老年冠心病合并肌少症的危险因素；当Cr/Cys C比值<0.7时，提示老年冠心病有合并肌少症的可能。更多还原

【Abstract】 Objective To investigate the correlation between serum creatinine/cystatin C ratio and sarcopenia in elderly patients with coronary heart disease.Methods Elderly patients with coronary heart disease who were hospitalized in the geriatric medical center, department of cardiology and physical examination center of the people’s Hospital of Inner Mongolia Autonomous Region from December 2020 to November 2021 were divided into coronary heart disease sarcopenia group and coronary heart disease non sarcopenia group according to whether they had sarcopenia.Results(1)The mean age of the elderly patients with sarcopenia was significantly higher than that of the non sarcopenia group(P=0.006);The incidence of sarcopenia increased with the increase of age in elderly patients≥60 years old;(2)There were more males than females in the sarcopenia group of elderly coronary heart disease(P<0.01);(3)The grip strength, left and right leg, left and right arm muscle mass, limb muscle mass and skeletal muscle mass index in the elderly patients with sarcopenia were significantly lower than those in the non sarcopenia group(P<0.01);(4)BMI,HDL-C and Cr in the sarcopenia group of elderly coronary heart disease were lower than those in the non sarcopenia group, the difference was statistically significant(P<0.05);TG,TC and Cys C were higher than those in the non sarcopenia group, the difference was statistically significant(P<0.05);(5)The Cr/Cys C ratio in the sarcopenia group was significantly lower than that in the non sarcopenia group(P<0.01);(6)Logistic regression analysis showed that among many factors such as gender, age, BMI, TG, TC, HDL-C,Cr/Cys-C,Sex(or=16.267,95% Cl 5.550-47.677,P<0.01),Age(or=1.063,95% Cl 1.018-1.111,P=0.006),BMI(or=0.879,95% Cl 0.777-0.996,P=0.042), Cr/Cys C(or=0.489,95% Cl 0.357-0.671,P<0.01)were the risk factors of coronary heart disease complicated with sarcopenia in the elderly;(7)ROC curve analysis showed that the sensitivity of Cr/Cys C ratio was 94%, the specificity was 65%, the yoden index was 0.594, the threshold was 0.7,and the area under the curve(AUC) was 0.766. When Cr/Cys C ratio was less than 0.7,the elderly coronary heart disease may be complicated with sarcopenia.Conclusion Age, Sex, BMI and Cr/Cys C ratio are the risk factors of coronary heart disease complicated with sarcopenia in the elderly; When Cr/Cys C ratio is less than 0.7,it suggests that elderly coronary heart disease may be complicated with sarcopenia.更多还原