老年冠心病患者合并衰弱综合征的影响因素研究

发布时间：2018-04-17 01:40

本文选题：冠心病 + 衰弱综合征　；参考：《中国全科医学》2017年19期

【摘要】：目的探讨老年冠心病患者合并衰弱综合征的影响因素,以为我国的衰弱诊断模型提供依据。方法选取2015-12-01至2016-05-30在新疆医科大学第一附属医院心内科住院治疗的老年冠心病患者365例。采用Fried衰弱症状学量表评估纳入患者的临床衰弱情况,进而将其分为非衰弱期组(n=251)、衰弱前期组(n=66)、衰弱期组(n=48)。比较3组患者的临床资料,采用多因素Logistic回归分析探讨老年冠心病患者合并衰弱综合征的影响因素。结果 3组患者年龄、BMI、冠心病特异性指数高危比例及合并糖尿病、慢性阻塞性肺疾病(COPD)、充血性心力衰竭、慢性肾功能不全、肿瘤、阿尔茨海默病、高尿酸血症、心律失常、老年瓣膜性心脏病、肺部感染发生率比较,差异有统计学意义(P0.05);3组患者白介素6(IL-6)、C反应蛋白(CRP)、纤维蛋白原(FIB)、脑利钠肽(BNP)、尿酸(UA)、血肌酐(Scr)、胱抑素C(Cys C)、清蛋白(ALB)、血红蛋白(Hb)、白细胞计数(WBC)、中性粒细胞计数比较,差异有统计学意义(P0.05)。多因素Logistic回归分析结果显示,相对于衰弱前期,年龄、合并肿瘤、BNP、UA、Scr、ALB、中性粒细胞计数是老年冠心病患者处于衰弱期的影响因素(P0.05);相对于非衰弱期,合并COPD、合并肿瘤、IL-6、BNP、UA、Scr、ALB是老年冠心病患者处于衰弱期的影响因素(P0.05)。结论年龄、合并COPD和肿瘤及IL-6、BNP、UA、Scr、ALB、中性粒细胞计数是老年冠心病患者合并衰弱综合征的影响因素,可以为制定衰弱诊断模型提供理论依据,同时有助于做出个体化诊疗决策。
[Abstract]:Objective to explore the influencing factors of senile patients with coronary heart disease (CHD) complicated with debilitating syndrome, and to provide evidence for diagnosis of senile coronary heart disease.Methods 365 elderly patients with coronary heart disease who were hospitalized in Department of Cardiology, first affiliated Hospital of Xinjiang Medical University from January 12 to May 30, 2016-05-30 were selected.The clinical status of debilitating patients was evaluated by using Fried's symptom scale, and then divided into two groups: non-asthenia group (n = 251), early stage group (n ~ (66)) and weak group (n ~ (48)).The clinical data of three groups of patients were compared and multivariate Logistic regression analysis was used to study the influencing factors of senile coronary heart disease patients with debilitating syndrome.Results BMI, high risk ratio of coronary heart disease specificity index and diabetes mellitus, chronic obstructive pulmonary disease (COPD), congestive heart failure, chronic renal insufficiency, tumor, Alzheimer's disease, hyperuricemia, arrhythmia were observed in three groups.The incidence of valvular heart disease and pulmonary infection in the elderly,The difference was statistically significant in the three groups of patients: interleukin 6, IL-6, C-reactive protein, fibrinogen, brain natriuretic peptide, uric acid, creatinine, cystatin C(Cys, albumin, hemoglobin, white blood cell count, neutrophil count, neutrophilic granulocyte count, neutrophilic granulocyte count, neutrophilic granulocyte count, neutrophilic granulocyte count, serum creatinine creatinine, cystatin C(Cys, albumin, hemoglobin, neutrophilic granulocyte count and neutrophil count.The difference was statistically significant (P 0.05).Multivariate Logistic regression analysis showed that the neutrophil count in elderly patients with coronary heart disease (CHD) was significantly affected by neutrophil count compared with pre-debilitating stage and age, compared with that in non-asthenia stage, and that the neutrophil count was a significant factor in the elderly patients with coronary heart disease in the debilitating stage (P 0.05).In elderly patients with coronary heart disease (CHD), patients with cod, BNPUAUAScr-ALB were associated with IL-6 and BNPUAA, and the risk factors were as follows: P0.05.Conclusion Age, combined with COPD and tumor and IL-6 BNPUAUAScr-ALB, neutrophil count are the influencing factors of senile patients with coronary heart disease complicated with debilitating syndrome, which can provide theoretical basis for the establishment of model for diagnosis of weakness and help to make individualized diagnosis and treatment decision at the same time.
【作者单位】：新疆医科大学第一附属医院干部病房综合内科VIP(二)病区;
【基金】：新疆维吾尔自治区自然科学基金资助项目(2016D01C303)
【分类号】：R541.4

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