门诊老年代谢病患者的共病现状调查

Comorbidity in elderly outpatients with metabolic diseases

目的 探讨门诊老年代谢病患者的共病罹患情况。方法 对在山西省人民医院老年医学科2013年9月至2016年6月就诊的300例≥65岁老年代谢病患者（2型糖尿病、高血压病、高脂血症）进行老年综合评估,对共病现状进行调查。结果 入组患者年龄（77±7）岁,患病1~24种,6种慢性病患病顺位依次为：高血压（55.0%）、糖尿病（41.7%）、高脂血症（37.3%）、冠心病（35.3%）、慢性阻塞性肺疾病（25.7%）、脑卒中（7.7%）;平均患老年综合征数3.4±1.7,视力障碍、听力障碍、认知损害、情绪障碍、睡眠障碍和便秘的发生率分别为12.7%、20.0%、37.0%、26.0%、56.0%和43.0%;与患慢性病数较少（慢性病数〈2种）患者比较,患慢性病数较多的患者（慢性病数≥2）视力障碍发生率（14.0%与2.7%）、听力障碍发生率（22.0%与5.6%）、认知损害发生率（41.7%与2.7%）、睡眠障碍发生率（61.4%与23.1%）和便秘发生率（48.1%与5.6%）均高于患慢性病数较少（慢性病数〈2）患者,且差异均有统计学意义（P〈0.05）。结论 老年代谢病患者多病共存现象显著,认知损害、情绪障碍、睡眠障碍和便秘等老年综合征发生率高,需要进行老年综合评估和个体化的管理。

Objective To investigate the prevalence of comorbidity in elderly outpatients with metabolic dis- eases. Methods A total of 300 elderly patients with metabolic diseases （type 2 diabetes mellitus, hypertension, and hyperlipidemia） aged 65 years or older, who were hospitalized in Shanxi Provincial People＇s Hospital between September 2013 and June 2016, were evaluated by the comprehensive geriatric assessment, and the comorbidity was investigate. Results The age of the included patients was （77±7） years old, with 1 to 24 types of eomorbidities. The prevalence of the 6 chronic diseases was as follows： hypertension （55.0%）, diabetes （41.7%）, hyperlipidemia （37.3%） coronary heart disease （35.3%）, chronic obstructive pulmonary disease （25.7%）, and stroke （7.7%）. The average num- ber of patients with geriatric syndrome was （3.4±1.7）. The prevalence of visual impairment, hearing impairment, cogni- tive impairment, emotional disorder, sleep disorders and constipation was 12.7%, 20.0%, 37.0%, 26.0%, 56.0% and 43.0%, respectively. The incidences of visual impairment, hearing impairment, cognitive impairment, sleep disorders and constipation in patients with ≥2 chronic diseases were higher than those in patients with 〈2 chronic diseases （14.0% vs 2.7%, 22.0% vs 5.6%, 41.7% vs 2.7%, 61.4% vs 23.1%, 48.1% vs 5.6%）, respectively. The differences were statistically significant （P〈0.05）. Conclusion The comorbidity in elderly outpatients with metabolic diseases is significant. The incidence of geriatric syndromes, such as cognitive impairment, emotional disorder, sleep disorders, and constipation is high, which needs comprehensive geriatric assessment and individualized mangement.