老年糖尿病周围神经病变患者衰弱现状及影响因素
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(琼海市中医院综合内科,海南 琼海 571400)

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R587.1

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海南省重点研发计划(ZDYF2021SHFZ229)


Statusquo and influencing factors of frailty in elderly patients with diabetic peripheral neuropathy
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(Department of Comprehensive Internal Medicine, Qionghai Traditional Chinese Medicine Hospital, Qionghai 571400, Hainan Province, China)

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    摘要:

    目的 探讨老年糖尿病周围神经病变(DPN)患者衰弱现状及影响因素。方法 回顾性分析2020年9月至2022年9月琼海市中医院收治的203例老年DPN患者的临床资料,根据生理衰弱评估量表将患者分为衰弱组(n=58)与非衰弱组(n=145),比较两组患者一般资料及实验室指标的差异。采用SPSS 22.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ2检验进行组间比较。通过受试者工作特征(ROC)曲线分析年龄、体质量指数(BMI)对老年DPN患者衰弱发生的预测价值。通过多因素logistic回归分析老年DPN患者衰弱发生的危险因素。结果 衰弱组女性、独居或养老机构、未婚/离异/丧偶、吸烟、糖尿病病程≥10年、焦虑或抑郁、睡眠障碍、合并其他大或微血管并发症患者占比显著高于非衰弱组,差异有统计学意义(χ2=11.106、15.304、20.382、23.889、12.931、9.633、33.274、7.337;P<0.05)。衰弱组患者年龄显著高于非衰弱组,而BMI显著低于非衰弱组,差异有统计学意义(t=22.653、2.621;P<0.05)。对年龄及BMI进行ROC分析,其对老年DPN患者衰弱发生有较好的预测价值,曲线下面积分别为0.986(95%CI 0.974~0.998;P<0.05)和0.898(95%CI 0.856~0.940;P<0.05)。多因素logistic回归分析显示,女性(OR=1.067,95%CI 1.002~1.136)、独居或养老机构(OR=3.450,95%CI 1.206~9.869)、未婚/离异/丧偶(OR=3.045,95%CI 1.524~6.084)、吸烟(OR=1.566,95%CI 1.038~2.363)、糖尿病病程≥10年(OR=1.389,95%CI 1.174~1.643)、焦虑或抑郁(OR=2.783,95%CI 1.250~6.196)、睡眠障碍(OR=1.305,95%CI 1.194~1.426)、合并其他大或微血管并发症(OR=4.197,95%CI 1.669~10.554)、年龄≥70.360岁(OR=1.873,95%CI 1.249~2.809)及BMI≤20.185kg/m2(OR=4.246,95%CI 1.588~11.353)为老年DPN患者衰弱发生的危险因素。结论 老年DPN患者具有较高的衰弱发生风险,且衰弱的发生受到诸多因素的影响,临床医师对此应予以关注。

    Abstract:

    Objective To investigate the status quo of frailty and its influencing factors in the elderly patients with diabetic peripheral neuropathy (DPN). Methods The clinical data of 203 elderly DPN patients admitted to Qionghai Hospital of Traditional Chinese Medicine from September 2020 to September 2022 were retrospectively analyzed. The patients were divided into frailty group (n=58) and non-frailty group (n=145) according to the Physiological Frailty Assessment Scale and the differences in basic data and laboratory indicators between the two groups were compared. SPSS statistics 22.0 was used for data analysis. According to the data type, t test or χ2 test was used to compare the groups. The predictive value of age and body mass index (BMI) for frailty in the elderly DPN patients was analyzed via receiver operating characteristic (ROC) curve. The risk factors of frailty in the elderly DPN patients were analyzed using multivariate logistic regression analysis. Results The proportion of women, those living alone or in nursing homes, unmarried/divorced/widowed, smoking, diabetic course≥ 10 years, anxiety or depression, sleep disorders, and other major or microvascular complications in the frailty group were significantly higher than those in the non-frailty group (χ2=11.106,15.304,20.382,23.889,12.931,9.633,33.274,7.337; P<0.05). Age of patients in frailty group was significantly higher than that in non-frailty group (t=22.653), and BMI was significantly lower than that in non-frailty group (t=2.621), with statistical significance (P<0.05). ROC analysis of age and BMI showed good predictive value for frailty in the elderly DPN patients, and the area under the curve was 0.986 (95%CI 0.974-0.998; P<0.05) and 0.898 (95%CI 0.856-0.940; P<0.05). Multivariate logistic regression analysis showed that women (OR=1.067,95%CI 1.002-1.136), living alone or in nursing homes (OR=3.450,95%CI 1.206-9.869), unmarried/divorced/widowed (OR=3.045,95%CI 1.524-6.084), smoking (OR=1.566,95%CI 1.038-2.363), diabetes≥10 years (OR=1.389,95%CI 1.174-1.643), anxiety or depression (OR=2.783,95%CI 1.250-6.196), sleep disorder (OR=1.305,95%CI 1.194-1.426), other major or microvascular complications (OR=4.197,95%CI 1.669-10.554), age≥70.360 years (OR=1.873,95%CI 1.249-2.809) and BMI≤20.185 kg /m2 (OR=4.246,95%CI 1.588-11.353) were the risk factors for frailty in the elderly DPN patients. Conclusion Elderly DPN patients have a high risk of frailty, its occurrence is affected by multiple factors, and clinicians should pay attention to it in the treatment of such patients.

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叶彩凤,黄蕊.老年糖尿病周围神经病变患者衰弱现状及影响因素[J].中华老年多器官疾病杂志,2024,23(5):327~331

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  • 收稿日期:2023-05-26
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  • 在线发布日期: 2024-05-15
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