上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (12): 1627-1631.doi: 10.3969/j.issn.1674-8115.2020.12.010

• 论著·临床研究 • 上一篇    下一篇

老年稳定性冠状动脉粥样硬化性心脏病患者合并衰弱综合征的影响因素分析

李 鑫*，梁馨月*，方宁远，汪海娅   

  1. 上海交通大学医学院附属仁济医院老年病科，上海 200001
  • 出版日期:2020-12-28 发布日期:2021-02-02
  • 通讯作者: 汪海娅，电子信箱：why7848@163.com。
  • 作者简介:李 鑫（1993—），女，硕士生；电子信箱：2508878651@qq.com。梁馨月（1984—），女，住院医师，硕士；电子信箱：starmoonww@hotmail.com。*为共同第一作者。
  • 基金资助:
    上海申康医院发展中心临床科技创新项目（SHDC20153178）。

Analysis of influencing factors of frailty syndrome in elderly patients with stable coronary artery disease

LI Xin*, LIANG Xin-yue*, FANG Ning-yuan, WANG Hai-ya   

  1. Department of Geriatrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
  • Online:2020-12-28 Published:2021-02-02
  • Supported by:
    Clinical Science and Technology Innovation Project of Shanghai Shenkang Hospital Development Center (SHDC20153178).

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摘要： 目的·分析老年稳定性冠状动脉粥样硬化性心脏病（冠心病）患者合并衰弱综合征的影响因素。方法·连续入选2019年3月—9月于上海交通大学医学院附属仁济医院老年病科及心内科进行住院治疗的稳定性冠心病患者101例（年龄≥60岁）。采用老年综合评估评价患者的健康状况及合并疾病情况。使用Fried衰弱表型评价患者的衰弱状态，并将其分为衰弱组和非衰弱组。采用多因素Logistic回归模型分析老年冠心病患者合并衰弱综合征的影响因素。结果·在101例老年冠心病患者中，合并衰弱综合征者53例。2组患者在年龄、Charlson共病指数、合并睡眠障碍比例、1年内跌倒史、多重用药史、握力、Gensini评分、胱抑素水平、脑钠钛（brain natriuretic peptide，BNP）和血肌酐（serum creatinine，Scr）水平间差异均具有统计学意义（均P<0.05）。多因素Logistic回归分析显示，Gensini评分（β=0.027，SE=0.012，P=0.028）和握力（β=-0.076，SE=0.030，P=0.012）均是老年稳定性冠心病患者合并衰弱综合征的影响因素。结论·老年稳定性冠心病患者易合并衰弱综合征。及时行Gensini评分和握力测定将有助于临床医师对衰弱综合征的早期识别和干预。

关键词: 稳定性冠状动脉粥样硬化性心脏病, 衰弱综合征, 老年

Abstract:

Objective · To analyze the influencing factors of frailty syndrome in elderly patients with stable coronary artery disease (SCAD). Methods · A total of 101 SCAD patients (aged≥60 years) hospitalized in the Department of Geriatrics and Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine from March to September, 2019, were selected. The comprehensive geriatric assessment was used to evaluate the health status and complications of the patients. According to patients’ frailty status evaluated by the Fried frailty phenotype, the patients were divided into frailty group and non-frailty group. Multivariate Logistic regression model was used to analyze the influencing factors of frailty syndrome in elderly patients with SCAD. Results · Among 101 elderly patients with coronary heart disease, 53 cases were complicated with frailty syndrome. There were statistically significant differences in age, Charlson comorbidity index (CCI), the proportion of sleep disorders, falls in the past year, history of multiple drug use, grip strength, Gensini score, cystatin level, brain natriuretic peptide (BNP) and serum creatinine (Scr) levels between the two groups (all P<0.05). Multivariate Logistic regression analysis showed that Gensini score (β=0.027, SE=0.012, P=0.028) and grip strength (β=-0.076, SE=0.030, P=0.012) were the influencing factors of elderly SCAD patients complicated with frailty syndrome. Conclusion · Elderly patients with SCAD are prone to be complicated with frailty syndrome. The Gensini score and grip strength measurement will help clinicians identify and intervene in frailty syndrome early.

Key words: stable coronary artery disease (SCAD), frailty syndrome, elderly

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