实用老年医学

实用老年医学 ›› 2021, Vol. 35 ›› Issue (8): 825-828.doi: 10.3969/j.issn.1003-9198.2021.08.009

• 临床研究 • 上一篇    下一篇

老年冠心病病人衰弱相关因素分析

曾鸣, 李璇, 丁静云, 吴维涛, 肖小华   

  1. 518035 广东省深圳市,深圳市第二人民医院老年医学科
  • 收稿日期:2021-02-10 出版日期:2021-08-20 发布日期:2021-08-30
  • 通讯作者: 肖小华,Email:tu_xi8888@163.com
  • 基金资助:
    广东省自然科学基金面上项目(2019A1515011927);深圳市科技计划项目(JCY20180507184647636)

Analysis of related factors of frailty in elderly patients with coronary heart disease

ZENG Ming, LI Xuan, DING Jing-yun, WU Wei-tao, XIAO Xiao-hua   

  1. Department of Geriatrics, Shenzhen Second People’s Hospital, Shenzhen 518035, China
  • Received:2021-02-10 Online:2021-08-20 Published:2021-08-30

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摘要： 目的 研究老年冠心病病人合并衰弱的相关危险因素。 方法 纳入2018年10月至2020年10月于我院收治的230例老年冠心病病人为研究对象。病人均检测手握力、步速,并进行5次起坐试验、3 m起立-行走试验、全足距测试。收集病人一般资料,包括年龄、性别、BMI、心功能分级,基础疾病及是否存在抑郁、焦虑,并统计相关生化指标。采用Fried衰弱症状学量表评估病人衰弱情况,并分为衰弱组和非衰弱组,采用多因素Logistic回归分析老年冠心病病人合并衰弱的独立影响因素。 结果 230例老年冠心病病人中,39例为衰弱前期,27例为衰弱期,共66例(28.70%),均纳入衰弱组;164例(71.30%)病人无衰弱,纳入非衰弱组。衰弱组年龄和5次起坐试验、3 m起立-行走试验时间均显著高于非衰弱组,Hb水平、手握力、步速均显著低于非衰弱组(P＜0.05);衰弱组心功能分级为Ⅱ级、合并抑郁、不能完成全足距测试的病人占比均显著高于非衰弱组(P＜0.05)。多因素Logistic回归分析显示,年龄(OR=1.421,95%CI:1.217～1.659)、心功能分级(OR=1.542,95%CI:1.086～2.189)、抑郁(OR=1.482,95%CI:1.246～1.763)、Hb(OR=1.427,95%CI:1.104～1.845)、手握力(OR=1.607,95%CI:1.214～2.127)、步速(OR=1.352,95%CI:1.104～1.656)、5次起坐时间(OR=1.413,95%CI:1.201～1.662)、3 m起立-行走时间(OR=1.541,95%CI:1.217～1.951)、不能完成全足距测试(OR=1.324,95%CI:1.075～1.631)是老年冠心病病人合并衰弱的独立影响因素(P＜0.05)。 结论 老年冠心病病人合并衰弱的发生风险较高,年龄、心功能分级、抑郁、Hb水平及肌肉功能检测指标是老年冠心病病人合并衰弱的独立影响因素。

关键词: 冠心病, 老年人, 衰弱, 肌肉功能

Abstract: Objective To study the risk factors of frailty in the elderly patients with coronary heart disease (CHD). Methods A total of 230 elderly patients with CHD admitted to our hospital from October 2018 to October 2020 were selected as the research objects. The hand grip strength, walking speed, five times sit up tests, 3 m stand up walk test and full foot distance test were evaluated in all patients. The general information of the patients was collected, including age, gender, body mass index(BMI), cardiac function classification, complications, depression and anxiety, and the laboratory biochemistry indexes were observed and analyzed. The patients were divided into the frail group and the non-frail group according to the evaluation of the Fried frailty criteria. The independent influencing factors of frailty were analyzed by multivariate Logistic regression. Results Of 230 cases of the elderly patients with CHD, there were 39 cases in prophase of frailty and 27 cases in phase of frailty, and they were enrolled in the frail group; And 164 cases(71.30%) withnot frailty were enrolled in the non-frail group. The age, 5 times sit up test and 3 m stand up walk test time of the frail group were significantly higher than those of the non-frail group, while the level of hemoglobin (Hb), hand grip strength and walking speed in the frail group were significantly lower than those in the non-frail group (P<0.05). The proportions of the patients with cardiac function grade Ⅱ, depression and unable to complete the full foot distance test of the frail group were significantly higher than those of the non-frail group (P<0.05). Multivariate Logistic regression analysis showed that age (OR=1.421,95%CI:1.217-1.659), cardiac function classification(OR=1.542,95%CI:1.086-2.189), depression(OR=1.482,95%CI:1.246-1.763),Hb(OR=1.427,95%CI:1.104-1.845), hand grip strength(OR=1.607,95%CI:1.214-2.127), walking speed(OR=1.352,95%CI:1.104-1.656), time of five times sit up test(OR=1.413,95%CI:1.201-1.662), time of 3 m standing walking (OR=1.541,95%CI:1.217-1.951), failure to complete the full foot distance test(OR=1.324,95%CI:1.075-1.631)were the independent risk factor for frailty in the elderly patients with CHD(P＜0.05). Conclusions Age, heart function grade, depression, Hb and muscle function test index are independent factors of frailty in the elderly patients with CHD.

Key words: coronary heart disease, aged, frailty, muscle function

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