摘要
目的探讨衰弱对老年高血压患者不良预后的影响。方法随机选取2015年3月至2016年10月在解放军总医院门诊就诊或常规查体的老年高血压患者314例为研究对象,对患者的一般人口学特征、既往病史等进行问卷调查,应用Charlson合并症指数(CCI)对老年患者的共病状态进行评估,微型营养评估简表(MNA-SF)进行营养评估,Barthel指数进行日常生活能力评估。依据衰弱状态分为3组:正常组(n=65)、衰弱前期组(n=208)和衰弱组(n=41)。进行18个月的随访,依据是否发生跌倒分为2组:跌倒组(n=41)和非跌倒组(n=273);依据是否发生全因住院分为2组:住院组(n=133)和非住院组(n=181)。采用SPSS 19.0软件进行数据处理。依据数据类型,组间比较分别采用t检验或χ~2检验。对单因素分析有统计学意义的指标进行多因素logistic回归分析,筛选出独立的危险因素。结果 314例老年高血压患者应用Fried标准共检出衰弱者41例,检出率为13.1%,且衰弱的检出率随年龄的增加而增加。经校正的回归模型显示,步速减低与跌倒具有显著相关性(OR=2.88,95%CI 1.26~6.56,P<0.05),步速减低与全因住院的相关性差异无统计学意义(OR=1.13,95%CI0.57~2.22,P=0.726)。结论老年高血压患者衰弱的检出率随年龄的增加而增加,步速减低是老年高血压患者发生跌倒的独立危险因素。
Objective To determine the effect of frailty on the prognosis in the elderly hypertensive patients. Methods A total of314 elderly hypertension patients who visited the Outpatient Department or took physical examination in our hospital from March 2015 to October 2016 were enrolled in this study. Their general demographic characteristics and medical history were collected by questionnaires. The comorbid conditions were evaluated with Charlson comorbidity index（ CCI）. Mini nutritional assessment-short form（ MNA-SF） was used for nutritional assessment,and Barthel index for daily life ability. According to the state of weakness,they were divided into normal（ n = 65）,pre-frialty（ n = 208） and frialty groups（ n = 41）. Based on the occurrence of falls during the 18 months＇ follow-up,the patients were also assigned into fall group（ n = 41） and non-fall group（ n = 273）,and into hospitalization group（ n = 133） and non-hospitalization group（ n = 181） according to all-cause hospitalization. SPSS statistics 19. 0 was used for data processing. Student＇s t test or Chi-square test was employed for intergroup comparison with different data types. The factors with significant difference by univariate analysis were further analyzed by multivariate logistic regression analysis to identify independent risk factors. Results Fried standard identified 41 frail patients out of the 314 subjects,with a detection rate of 13. 1%,and the rate was increased with age. After adjustment,the regression model showed that pace reduction was associated with increased risk for fall（ OR = 2. 88,95% CI 1. 26-6. 56,P〈0. 05）,but not with all-cause hospitalization（ OR = 1. 13,95% CI 0. 57-2. 22,P = 0. 726）.Conclusion The prevalence of frailty in elderly hypertensive patients is increased with age. Pace reduction is an independent risk factor for incidence of fall in them.
作者
李建华
范利
赵婷
库洪安
王蓉
邹晓
胡亦新
LI Jian-Hua;FAN Li;ZHAO Ting;KU Hong-An;WANG Rongz;ZOU Xiao;HU Yi-Xin(Department of Geriatric Cardiology;Department of Outpatient;Intensive Care Unit of South Building;Health Care Department of South Building, Chinese PLA General Hospital, Beijing 100853, China)
出处
《中华老年多器官疾病杂志》
2018年第5期324-328,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
军队保健专项课题(15BJZ41)~~
关键词
老年人
高血压
衰弱
预后
aged
hypertension
frailty
prognosis
