【摘要】 目的 探讨肌少症指数（sarcopenia index ,SI）对新型冠状病毒肺炎患者预后的预测价值。方法 收集2022年12月～2023年2月于苏州大学附属第一医院住院治疗的221例新型冠状病毒肺炎患者的临床资料，计算中性粒细胞与淋巴细胞比值（NLR）、C反应蛋白（CRP）与白蛋白比值（CAR）、预后营养指数（PNI）、SI、SI5（入院后5d SI）、ΔSI5（入院后5d SI-入院当日SI）、SI10（入院后10d SI）和ΔSI10（入院后10d SI-入院后5d SI），且通过类推计算SI15、ΔSI15、SI20、ΔSI20。将患者分为生存组（n=161）和死亡组（n=60），比较两组之间上述指标差异。结果 两组白细胞（WBC）、CRP、降钙素原（PCT）、白细胞介素-6(IL-6)、D-二聚体、NLR、SI、CAR、PNI水平比较，差异具有统计学意义（P<0.05）。两组SI、SI20水平差异有统计学意义（均P<0.05）。二分类多因素Logistic回归分析结果显示，SI和IL-6为影响新型冠状病毒肺炎患者预后的独立因素（均P<0.05）。SI的ROC曲线下面积为0.733，敏感度为71.1%，特异度为64.4%;IL-6的ROC曲线下面积为0.719，截断值为17.38 pg/mL，敏感度为64.2%，特异度为71.7%;SI与IL-6联合的ROC曲线下面积为0.803，敏感度为93.5%，特异度为54.8%。结论 SI和IL-6是新型冠状病毒肺炎患者预后的独立危险因素，二者联合预测预后效果最好。更多还原

【Abstract】 Objective To explore the predictive value of sarcopenia index for the prognosis of patients with coronavirus disease 2019. Methods The clinical data of 221 patients with coronavirus disease 2019 admitted to the First Affiliated Hospital of Soochow University from Dec 2022 to Feb 2023 were collected, and the neutrophil-to-lymphocyte ratio(NLR), C-reactive protein-to-albumin ratio(CAR), prognostic nutritional index(PNI), SI, SI5(SI on the 5 th day after admission), ΔSI5(SI on the 5 th day after admission-SI on the day of admission), SI10(SI on the 10 th day after admission), and ΔSI10(SI on the 10 th day after admission-SI on the 5 th day after admission) were calculated. By analogy, SI15, ΔSI15, SI20, and ΔSI20 were further calculated. The patients were divided into the survival group(n=161) and the death group(n=60), and the differences in the above indicators between the two groups were compared. Results There were statistically significant differences in the levels of white blood cell(WBC), CRP, procalcitonin(PCT), interleukin-6(IL-6), D-dimer, NLR, SI, CAR, and PNI between the two groups(P<0.05). The differences in SI and SI20 levels between the two groups were also statistically significant(all P<0.05). Binary logistic regression analysis showed that SI and IL-6 were independent risk factors for the prognosis of coronavirus disease 2019 patients(all P<0.05). The area under the ROC curve of SI was 0.733, with a sensitivity of 71.1 % and a specificity of 64.4 %; the area under the ROC curve of IL-6 was 0.719, with a cutoff value of 17.38 pg/mL, a sensitivity of 64.2 %, and a specificity of 71.7 %; the area under the ROC curve of SI combined with IL-6 was 0.803, with a sensitivity of 93.5 % and a specificity of 54.8 %. Conclusion SI and IL-6 are independent risk factors for the prognosis of coronavirus disease 2019 patients, and their combination has the best prognostic predictive effect.更多还原