老年ACS患者合并衰弱综合征的危险因素及预后分析  

Risk factors and prognosis of frailty syndrome in elderly patients with acute coronary syndrome

作　　者：胡经文[1] 王小芹[2] 李铤 孟恬宇 苏显明[2] HU Jingwen;WANG Xiaoqin;LI Ting;MENG Tianyu;SU Xianming(The First Affiliated Hospital of Xi’an Jiaotong University:1.Department of Cardiology;Department of Geriatrics Cardiovascular,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院心内科,陕西西安710061 [2]西安交通大学第一附属医院老年心血管科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2022年第3期413-418,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金项目(No.82000474);西安交通大学第一附属医院新医疗新技术项目(No.XJYFY-2020N30)。

摘　　要：目的分析老年急性冠脉综合征(acute coronary syndrome,ACS)患者合并衰弱综合征的危险因素及对预后的影响。方法选择2020年9月至2021年2月在西安交通大学第一附属医院心血管内科和老年心血管科住院的65岁及以上的老年ACS患者,采用中文修订版Tilburg衰弱量表将患者分为衰弱综合征组和非衰弱综合征组。评估患者的日常生活活动能力、营养、抑郁、睡眠质量,测定总胆固醇、三酰甘油、低密度脂蛋白等指标,应用log-binomial回归分析衰弱综合征的危险因素并统计患者住院期间和出院30 d内的不良事件发生率。结果共纳入250例老年ACS患者,118例患者合并衰弱综合征,衰弱综合征的患病率为47.2%,衰弱综合征组与非衰弱综合征组的衰弱综合征评分具有统计学差异(11.06±2.53 vs.5.77±1.54,P<0.01);多因素回归分析显示,年龄(PR=2.01,95%CI:1.81~2.22;P<0.001)、高血压(PR=1.20,95%CI:1.09~1.30;P<0.001)、慢性肾脏疾病(PR=1.16,95%CI:1.04~1.29;P=0.012)、NT-proBNP(PR=1.20,95%CI:1.07~1.35;P=0.004)为老年ACS患者发生衰弱综合征的独立危险因素;衰弱综合征组患者住院期间心律失常和肺部感染发生率以及出院后30 d内再入院率明显高于非衰弱综合征组(P<0.05)。结论老年ACS患者合并衰弱综合征的患病率较高。高龄、高血压、慢性肾脏疾病和高NT-proBNP会增加衰弱综合征发生的风险,对患者的短期预后产生不良影响;临床工作中应加强关注上述因素,及时给予合理干预。Objective To investigate the risk factors of frailty syndrome in elderly patients with acute coronary syndrome(ACS)and their impact on prognosis. Methods The elderly patients with ACS aged 65 and over, who were hospitalized in the Department of Cardiology and Geriatric Cardiology of The First Affiliated Hospital of Xi’an Jiaotong University from September 2020 to February 2021,were selected in the cross-sectional survey. The patients were divided into frailty syndrome and non-frailty syndrome groups via the Chinese revised version of Tilburg Frailty Scale. We collected the patients’ activities of daily living, nutrition, depression, sleep quality, total cholesterol, triglycerides, lowdensity lipoprotein, and adverse events during hospitalization and within 30 days of discharge. We then performed LOGBINOMIAL regression to analyze the risk factors of frailty syndrome. Results A total of 250 elderly ACS patients were enrolled,and 118 patients were diagnosed with frailty syndrome with 47. 2% prevalence of frailty syndrome. There was a significant difference in the average score between the frailty syndrome group and the non-frailty syndrome group(11. 06±2. 53 vs. 5. 77±1. 54,P<0. 01). Multivariate regression analysis revealed that age(PR=2. 01 CI:1. 81-2. 22,P<0. 001),hypertension(PR=1. 20 CI:1. 09-1. 30,P<0. 001),chronic kidney disease(PR=1. 16 CI:1. 04-1. 29,P=0. 012),and NT-proBNP(PR=1. 20 CI:1. 07-1. 35,P=0. 004)were risk factors for frailty syndrome in elderly ACS patients.The incidence of arrhythmia and pulmonary infection during hospitalization and the rate of readmission within 30 days after discharge were significantly higher in the frailty syndrome group than those in the non-frailty syndrome group(P<0. 05).Conclusion There is a higher incidence of frailty syndrome in elderly patients with ACS. Older age, hypertension,chronic kidney disease and high NT-proBNP can increase the risk of frailty syndrome. In clinical practice,attention should be paid to the above factors,and reasonable intervention should

关 键 词：老年 急性冠脉综合征 衰弱综合征 危险因素 预后 

分 类 号：R714.252[医药卫生—妇产科学]