【摘要】 肌少症是一种以骨骼肌量和肌力进行性下降为特征的老年综合征，显著增加老年人跌倒、失能风险，严重影响老年人的生活质量。我国基层医疗服务机构对于肌少症的认识与研究起步较晚，作为肌少症防控的主战场，亟需规范化的管理方案。本方案由北京市月坛社区卫生服务中心牵头，基于国内外最新共识与指南，经全科医学、老年医学、营养学、康复医学等多学科专家团队反复讨论制定，旨在为基层医疗工作者提供系统指导。该方案内容包括：明确以65岁以上社区老年人为重点管理对象，遵循“预防为主、防治结合”及“个性化干预”原则；构建以全科医生为核心，联合护士、康复师、营养师的多学科协作团队；强调通过线上线下结合开展科普教育；利用小腿围、SARC-CalF量表、握力测试进行早期筛查；采用肌量、肌力及躯体功能综合评估和诊断；以营养及运动干预为核心，推荐每日蛋白质摄入≥1.2 g/(kg·d)并适当补充维生素D,同时结合抗阻与有氧训练，制定个体化运动处方；并建立转诊标准与随访机制，旨在规范社区肌少症管理流程，改善患者肌肉功能，实现科学防治。更多还原

【Abstract】 Sarcopenia is a geriatric syndrome characterized by progressive loss of skeletal muscle mass and strength, which significantly increases the risk of falls and disability among older adults and severely impairs quality of life. In China, primary healthcare institutions have relatively limited experience in the recognition and management of sarcopenia, and standardized management strategies remain lacking. As the frontline of sarcopenia prevention and control, primary care settings require practical and evidence-based management protocols. This program was led by the Yuetan Community Health Service Center in Beijing and developed based on the latest domestic and international consensus and guidelines. It was formulated through repeated discussions by a multidisciplinary expert team including general practitioners, geriatricians, nutritionists, and rehabilitation specialists. It aims to provide systematic guidance for primary healthcare workers. The program identified adults aged 65 years and older as the primary management population and follows the principles of "prevention first, combining prevention and treatment" and "personalized intervention". A multidisciplinary collaborative model is established, with general practitioners at the core coordinators and support from nurses, rehabilitation specialists, and nutritionists. Emphasized health education and public awareness through both online and offline chan-nels. Early screening is conducted using calf circumference, SARC-CalF questionnaire, and handgrip strength testing, followed by comprehensive assessment and diagnosis based on muscle mass, muscle strength, and physical performance. Interventions focus on nutrition and exercise, recommending a daily protein intake of ≥1.2 g/kg body weight with appropriate vitamin D supplementation, combined with resistance and aerobic exercise to develop individualized exercise prescriptions. Referral criteria and follow-up mechanisms are also clearly defined. The goal is to standardize community-based sarcopenia management procedures, improve muscle function in older adults, and achieve evidence-based prevention and treatment of sarcopenia.更多还原