高龄住院患者血清学指标与衰弱程度相关性分析

Analysis of the correlation between serum indexes and the degree of frailty in elderly inpatients

目的分析血清25-羟基维生素D[25(OH)D]、白细胞介素10(IL-10)、D-二聚体(D-D)水平与高龄住院衰弱患者衰弱程度的相关性。方法选取浙江省立同德医院420例高龄住院患者作为研究对象,其中衰弱组47例,非衰弱组373例。比较衰弱组、非衰弱组,衰弱组中不同衰弱程度患者、再入院与未再入院患者血清25(OH)D、IL-10、D-D水平,分析高龄住院患者衰弱发生的影响因素,探讨血清各指标与衰弱程度的相关性及对高龄住院伴衰弱患者再入院的预测价值。结果年龄、住院时间、血清25(OH)D、IL-10、D-D均为高龄住院患者衰弱发生的重要危险因素(OR=4.847、5.887、0.580、4.820、5.120,均P<0.05);血清25(OH)D水平(r=-0.415)与高龄住院伴衰弱患者衰弱程度呈负相关性,IL-10(r=0.379)、D-D(r=0.392)水平与衰弱程度呈正相关性(均P<0.05);血清25(OH)D、IL-10、D-D联合预测高龄住院伴衰弱患者再入院的曲线下面积为0.844,敏感性为80.96%,特异性为80.77%。结论血清25(OH)D、IL-10、D-D水平异常表达与衰弱程度相关,三者联合可为预测高龄住院伴衰弱患者再入院提供循证指导。

Objective To analyze the correlation between serum 25-hydroxyvitamin D[25(OH)D],interleukin-10(IL-10),D-dimer(D-D)levels and the degree of frailty in elderly hospitalized frail patients.Methods A total of 420 elderly inpatients in our hospital were selected as the research objects,including 47 in the frailty group and 373 in the non-frailty group.The serum 25(OH)D,IL-10 and D-D levels of patients with different degrees of debilitating and re-admitted and non-re-admitted patients were compared between the two groups.The influencing factors of the occurrence of frailty in elderly inpatients were analyzed,and the correlation between serum indexes and the degree of frailty and the predictive value of re-admission to elderly frail patients were discussed.Results Age,length of hospital stays,25(OH)D,IL-10,and D-D were all important risk factors for frailty in elderly hospitalized patients(OR=4.847,5.887,0.580,4.820,5.120,all P<0.05).Serum 25(OH)D level(r=-0.415)was negatively correlated with the degree of frailty in elderly hospitalized patients with frailty.IL-10(r=0.379)and D-D(r=0.392)levels were positively correlated with the degree of frailty(P<0.05).The area under the curve predicted by the combination of serum 25(OH)D,IL-10,and D-D for re-admission of elderly hospitalized patients with frailty was 0.844,the sensitivity was 80.96%,and the specificity was 80.77%.Conclusion The abnormal expression of serum 25(OH)D,IL-10 and D-D levels is related to the degree of frailty.The combination of the three can provide evidence-based guidance for predicting the re-admission of elderly hospitalized patients with frailty.