90岁及以上老年原发性高血压患者共病情况及与常见老年事件的相关性  

Comorbidity of essential hypertension patients aged 90 years and over and its correlation with common elderly events

作　　者：陈玉菲 杨萍 Chen Yufei;Yang Ping(First Ward of Integrated Geriatrics,the Jin Qiu Hospital of Liaoning Province,Liaoning Geriatric Hospital,Shenyang 110016,China)

机构地区：[1]辽宁省金秋医院辽宁省老年病医院综合老年医学科一病房,沈阳110016

出　　处：《中国心血管杂志》2020年第1期35-39,共5页Chinese Journal of Cardiovascular Medicine

摘　　要：目的调查90岁及以上老年原发性高血压患者共病情况,并对其与常见老年事件的相关性进行分析。方法采用横断面调查方法,入选2017年1~12月于辽宁省金秋医院(辽宁省老年病医院)住院治疗的年龄≥90岁的老年共病患者419例。根据是否患有高血压分为高血压组和对照组,比较两组一般资料差异。收集患者的共病种类,统计数量并采用Charlson共存病指数(CCI)对共病严重程度进行评价。采用Spearman相关分析计算入院时血压水平与CCI的相关性,应用多元线性回归分析CCI与心房颤动、脆性骨折、肺炎、尿路感染、植入起搏器状态、管饲、导尿、催眠药物使用及通便药物使用等老年事件的相关性。结果入选患者总体CCI评分为(4.0±2.2)分,校正年龄后评分为(8.0±2.2)分,总体共病数为(7.7±2.6)种。高血压组患者289例,占全部患者69.0%,其中男性202例,女性87例。高血压组与对照组比较:CCI评分为(4.6±2.1)分比(2.8±1.9)分,t=8.261,P=0.000;共病数量(8.3±2.5)种比(6.3±2.4)种,t=7.568,P=0.000;收缩压(133.81±13.31)mmHg比(124.91±11.61)mmHg,t=6.922,P=0.000;舒张压(72.24±7.56)mmHg比(69.68±7.25)mmHg,t=3.304,P=0.001。采用Spearman相关分析提示,CCI与血压水平存在相关性(r=0.101,P=0.039)。多元线性回归分析提示,CCI与脆性骨折、肺炎、尿路感染、管饲、催眠药使用及通便药使用独立相关(均为P<0.05)。结论90岁及以上老年原发性高血压患者在共病数量及程度上较无高血压者更明显,CCI与血压水平存在相关性,老年共病伴有更多的脆性骨折、肺炎、尿路感染、管饲、催眠药使用及通便药使用。Objective To investigate the comorbidity of essential hypertension patients aged 90 years and over and to analyze its correlation with common elderly events.Methods A cross-sectional survey method was used to select 419 elderly patients aged≥90 years old who were hospitalized in Jinqiu Hospital of Liaoning Province(Liaoning Geriatric Hospital)rom January to December 2017.The patients were divided into hypertension group and control group according to whether they had hypertension.The difference of general data between the two groups was compared.The types of co-diseases were collected and the severity of comorbidities was evaluated by Charlson coexisting disease index(Charlson Comorbidity Index,CCI).Spearman correlation analysis was used to calculate the correlation between blood pressure and CCI at admission.Multivariate linear regression analysis was used to analyze CCI and atrial fibrillation,senile osteoporosis fracture,pneumonia,urinary tract infection,pacemaker implantation status,tube feeding,catheterization,hypnotic drug use and laxative use.Results The total CCI score of selected patients was 4.0±2.2,the age corrected score was 8.0±2.2,and the total number of comorbities was 7.7±2.6.There were 289 cases in hypertension group,accounting for 69.0%of all patients,202 cases were males and 87 cases were females.CCI score was 4.6±2.1 vs.2.8±1.9(t=8.261,P=0.000);total number of diseases 8.3±2.5 vs.6.3±2.4(t=7.568,P=0.000);systolic blood pressure(133.81±13.31)mmHg vs.(124.91±11.61)mmHg(t=6.922,P=0.000);diastolic blood pressure(72.24±7.56)mmHg vs.(69.68±7.25)mmHg(t=3.304,P=0.001)in hypertension group compared with control group.Spearman correlation analysis showed that there was a correlation between CCI and blood pressure level(r=0.101,P=0.039).Multiple linear regression analysis showed that CCI was dependent of osteoporosis fracture,pneumonia,urinary tract infection,tube feeding,hypnotic use and defecation drug use(all P<0.05).Conclusions The number and degree of comorbidities in elderly patients w

关 键 词：老年人 90以上 共病现象 Charlson共存病指数 老年事件 

分 类 号：R544.11[医药卫生—心血管疾病]