武汉市某医院老年慢性阻塞性肺疾病住院患者发生衰弱现状及影响因素分析
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(1.华润武钢总医院综合医疗科,武汉430080;2.华中科技大学同济医学院附属协和医院普外科,武汉430022)

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R563.9

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湖北省卫生健康委科研项目(WJ2019F001;WJ2021M249)


Prevalence and influencing factors of frailty in elderly patients with chronic obstructive pulmonary disease in a hospital in Wuhan city
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(1.Department of General Medicine, China Resources WISCO General Hospital, Wuhan 430080,China;2. Department of General Surgery, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022,China)

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    摘要:

    目的 调查老年慢性阻塞性肺疾病(COPD)住院患者发生衰弱现状,并分析其影响因素。方法 采用便利抽样法选取2021年1月至2022年12月华润武钢总医院住院的260例老年COPD住院患者为研究对象。采用自制一般资料问卷对患者开展调查,使用临床衰弱量表对患者的衰弱状况进行评估,检测血红蛋白、25-羟基维生素D(25-OH-D)、白细胞介素-6(IL-6)水平,采用单因素及多因素logistic回归分析老年COPD住院患者发生衰弱的影响因素。采用SPSS 25.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ2检验。结果 本研究共发出调查问券260份,收回260份(100.00%),其中发生衰弱患者67例(25.77%)。性别、年龄、吸烟、锻炼习惯、营养状态、疾病严重程度和肺功能是老年COPD住院患者发生衰弱的影响因素(P<0.05);衰弱组患者的血红蛋白、25-OH-D水平显著低于未衰弱组,IL-6水平显著高于为衰弱组,差异有统计学意义(P<0.05);根据logistic回归分析得知性别、年龄、吸烟、锻炼习惯、营养状态、疾病严重程度、肺功能、血红蛋白低表达、25-OH-D低表达、IL-6高表达是老年COPD住院患者发生衰弱的危险因素(OR=3.174,1.556,3.162,1.735,2.649,5.089,2.162,1.314,1.974,2.173;P<0.05)。结论 武汉市某医院老年COPD住院患者衰弱的发生率较高,性别、年龄、吸烟、锻炼习惯、营养状态、疾病严重程度、肺功能、血红蛋白、25-OH-D、IL-6水平均有影响,临床上应进行合理的干预,从而减少衰弱的发生。

    Abstract:

    Objective To investigate frailty in the elderly inpatients with chronic obstructive pulmonary disease (COPD) and to analyze its influencing factors. Methods A total of 260 elderly COPD inpatients in China Resources WISCO General Hospital from January 2021 to December 2022 were selected by convenience sampling. A self-made questionnaire was used to gather patients′ general information. The patient′s frailty was assessed using the Clinical Frailty Scale. Hemoglobin, 25-hydroxyvitamin D (25-OH-D), interleukin-6 (IL-6) were measured. Univariate and multivariate logistic regression analysis were performed to analyze the influencing factors of frailty in the elderly COPD inpatients. SPSS statistics 25.0 was used for statistical analysis. Data comparison between two groups was perfomed using t test or χ2 test depending on data type.Results A total of 260 questionnaires were distributed and 260 (100.00%) were recovered. Among the 260 patients, 67 (25.77%) developed frailty. Gender, age, smoking, exercise habits, nutritional status, disease severity and lung function were the influencing factors for frailty in the elderly COPD inpatients (P<0.05). The levels of hemoglobin and 25-OH-D in the frailty group were significantly lower than those in the non-frailty group, the levels of IL-6 in the frailty group were significantly higher than those in the frail group, and the differences were statistically significant (P<0.05). Logistic regression analysis showed gender, age, smoking, exercise habits, nutritional status, disease severity, lung function, low hemoglobin expression, low 25-OH-D expression, and high IL-6 expression were risk factors for frailty in the elderly COPD inpatients (OR=3.174,1.556,3.162,1.735,2.649,5.089,2.162,1.314,1.974,2.173; P<0.05). Conclusion The incidence of frailty among the elderly COPD inpatients in the hospital in Wuhan is high and is affected by gender, age, smoking, exercise habits, nutritional status, disease severity, lung function, hemoglobin, 25-OH-D, and IL-6 levels. Reasonable clinical intervention should be offered to reduce the incidence of frailty.

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程忠良,曾肃友,赵媛媛,凌燕.武汉市某医院老年慢性阻塞性肺疾病住院患者发生衰弱现状及影响因素分析[J].中华老年多器官疾病杂志,2024,23(1):23~26

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  • 收稿日期:2023-03-29
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  • 在线发布日期: 2024-01-28
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