老年慢性阻塞性肺疾病患者衰弱危险因素分析及其与氧化应激的相关性  

Risk factors of frailty in older adult patients with chronic obstructive pulmonary disease and its correlation with oxidative stress

作　　者：黎娇[1] 谢静茹[1] 王光霞 Li Jiao;Xie Jingru;Wang Guangxia(Department of Geriatrics,Pingxiang People's Hospital,Pingxiang 337000,Jiangxi Province,China)

机构地区：[1]萍乡市人民医院老年医学科,萍乡337000

出　　处：《中国基层医药》2024年第5期681-685,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：江西省卫生健康委科技计划(202311715)。

摘　　要：目的分析老年慢性阻塞性肺疾病(COPD)患者衰弱的相关危险因素及其与氧化应激的相关性。方法采用便利抽样法,选取2022年8月至2023年8月在萍乡市人民医院住院治疗的≥60岁的COPD患者168例为研究对象,根据衰弱评估量表(FRAIL量表)评分结果进行分组,≥3分为衰弱组(n=109),<3分为无衰弱/衰弱前期组(n=59),其中1~2分为衰弱前期组(n=23),0分为无衰弱组(n=36)。检测各组血清8-羟基脱氧鸟苷(8-OHdG)、丙二醛(MDA)及总抗氧化能力(T-AOC)水平,采用单因素方差分析比较各组间差异,并进行相关性分析,采用logistic回归分析衰弱发生的危险因素。结果168例老年COPD患者衰弱的发生率为64.9%(109/168)。多因素logistic回归分析显示,年龄(OR=1.59,95%CI 1.02~2.25)、身体质量指数(OR=4.11,95%CI 2.02~8.42)、合并症(OR=2.57,95%CI 1.31~5.02)、日常生活活动能力(OR=3.07,95%CI 1.54~6.06)、营养不良(OR=2.97,95%CI 1.56~5.41)和认知功能障碍(OR=2.87,95%CI 1.42~5.88)是老年COPD患者衰弱的危险因素(均P<0.05)。老年COPD患者衰弱评分与血清8-OHdG、MDA均呈明显正相关(r=0.67、0.65,P=0.008、0.006),与T-AOC呈负相关(r=-0.54,P=0.012)。结论老年COPD患者年龄、身体质量指数、合并症、日常生活活动能力、营养不良和认知功能障碍是发生衰弱的危险因素,其严重程度与氧化应激产物水平明显相关。Objective To analyze the risk factors for frailty in older adult patients with chronic obstructive pulmonary disease(COPD)and its correlation with oxidative stress.Methods A total of 168 patients with COPD aged 60 years and above,who were treated at Pingxiang People's Hospital from August 2022 to August 2023,were selected as the study subjects using the convenient sampling method.The FRAIL scale was utilized to assess frailty status.Patients were divided into two groups based on their FRAIL scale scores:the frail group(≥3 points,n=109),the non-frail/pre-frail group(<3 points,n=59).Patients in the non-frail/pre-frail group were sub-divided into the pre-frail group(1-2 points,n=23),and the non-frail group(0 points,n=36).Serum levels of 8-hydroxydeoxyguanosine and malondialdehyde,and total antioxidant capacity were measured.One-way analysis of variance was performed to compare differences between groups,and correlation analysis was conducted.Logistic regression was used to identify the risk factors for frailty.Results The incidence of frailty among 168 older adult patients with COPD was 64.9%(109/168).Multivariable logistic regression analysis revealed that age(OR=1.59,95%CI 1.02-2.25),body mass index(OR=4.11,95%CI 2.02-8.42),comorbidities(OR=2.57,95%CI 1.31-5.02),activities of daily living(OR=3.07,95%CI 1.54-6.06),malnutrition(OR=2.97,95%CI 1.56-5.41),and cognitive impairment(OR=2.87,95%CI 1.42-5.88)were risk factors for frailty in older patients with COPD(P<0.05).The frailty scores of older adult patients with COPD were significantly positively correlated with serum levels of 8-hydroxydeoxyguanosine and malondialdehyde(γ=0.67,0.65,P=0.008,0.006),and negatively correlated with total antioxidant capacity(γ=-0.54,P=0.012).Conclusion Age,body mass index,comorbidities,activities of daily living,malnutrition,and cognitive impairment are risk factors for frailty in older adult patients with COPD,and the severity of frailty is markedly associated with levels of oxidative stress products.

关 键 词：肺疾病 慢性阻塞性 虚弱 危险因素 氧化性应激 丙二醛 抗氧化能力指数 因素分析 统计学 老年人 

分 类 号：R563.9[医药卫生—呼吸系统]