老年衰弱症及其表型与贫血的相关性研究

Association of frailty phenotype with anemia in the elderly

目的探讨老年衰弱症及其表型与贫血的相关性。方法选择老年科住院的≥65岁衰弱症患者和非衰弱症患者各138例,应用Frie d衰弱症表型诊断标准评估衰弱状态,检测RBC、Hb、红细胞比容、红细胞分布宽度、平均红细胞体积等贫血相关指标,并分析衰弱症及其表型与贫血指标间的关系。结果衰弱症组平均年龄明显高于非衰弱症组,握力、RBC、Hb水平均明显低于非衰弱症组,差异均有统计学意义(均P<0.01);两组患者性别、BMI、红细胞比容、红细胞分布宽度、平均红细胞体积等比较,差异均无统计学意义(均P>0.05)。体重下降、疲乏、握力下降、体能下降、步速下降、衰弱症的患者RBC、Hb水平均明显降低(均P<0.05);步速下降的患者红细胞分布宽度亦明显降低(P<0.05)。logistic回归分析提示年龄增长(OR=1.168,95%CI:1.111~1.229,P<0.01)、Hb水平下降(OR=0.945,95%CI:0.903~0.990,P<0.05)是老年衰弱症的独立危险因素。结论年龄增长、Hb水平下降是老年衰弱症的独立危险因素。

Objective To investigate the association between frailty phenotype and anemia in the elderly. Methods Twohundred seventy six inpatients aged 65 years or older were recruited from department of geriatrics in Zhejiang Hospital, including138 cases with frailty （frailty group） and 138 cases without frailty （non-frailty group）. Fried frailty phenotype criteria was used toassess the frailty status, and anemia related parameters including red blood cell count （RBC）, hemoglobin level （Hb）, hematocrit,red cell distribution width and mean corpuscular hemoglobin concentration were measured. The correlation between frailtyphenotype components and anemia related-parameters was analyzed. Results Compared with non-frailty group, the age ofpatients in frailty group was older, and the grip strength, RBC, Hb level were lower （all P〈0.01）. No significant differences wereobserved in sex, body mass index （BMI）, hematocrit, red cell distribution width and mean corpuscular hemoglobin concentrationbetween two groups （all P〉0.05）. Patients with weight loss, exhaustion, low grip strength, low physical activity, slow gait speedand frailty had significantly lower RBC and Hb levels （all P〈0.05）. Patients with slow gait speed had lower red cell distributionwidth（P〈0.05）. Logistic regression analysis revealed that older age（OR=1.168, 95%CI： 1.111-1.229, P〈0.01） and low Hb level（OR=0.945, 95%CI：0.903-0.990, P〈0.05） were independent risk factors of frailty. Conclusion Aging and low Hb level both areindependent risk factors of frailty in the elderly.