老年慢性阻塞性肺疾病合并吞咽障碍患者的衰弱现状及其影响因素

Current Status of Frailty and Its Influencing Factors of Elderly Patients with Chronic Obstructive Pulmonary Disease Complicated with Dysphagia

目的了解老年慢性阻塞性肺疾病(COPD)合并吞咽障碍患者的衰弱现状并分析其影响因素,为制定预防和干预措施提供依据。方法选取2019年4月至2020年4月在宁夏9所医院呼吸内科住院的201例老年COPD合并吞咽障碍患者作为研究对象。使用一般资料调查表、衰弱筛查量表(FRAIL)、COPD评估测试(CAT)、巴氏指数(BI)、微型营养评定法简表(MNA-SF)及老年抑郁量表(GDS)进行调查与评估。结果老年COPD合并吞咽障碍患者的衰弱发生率为66.17%。不同年龄、婚姻状况、合并并发症数量、病程、COPD严重程度、日常生活活动(ADL)能力、抑郁状况的老年COPD合并吞咽障碍患者的衰弱情况比较,差异有统计学意义(P<0.05)。二元logistic回归分析结果显示,年龄、COPD严重程度、ADL能力、抑郁状况是老年COPD合并吞咽障碍患者发生衰弱的影响因素(P<0.05)。结论老年COPD合并吞咽障碍患者的衰弱发生率较高。在临床中医生应加强对高龄、COPD病情重、ADL能力较低及伴抑郁症状的老年COPD合并吞咽障碍患者的评估,早期识别危险因素以避免和减少衰弱带来的负性事件,改善患者生活质量。

Objective To understand the current status of frailty of elderly patients with chronic obstructive pulmonary disease(COPD)complicated with dysphagia and analyze its influencing factors,in order to provide basis for formulating prevention and intervention measures.Methods A total of 201 elderly patients with COPD complicated with dysphagia who were hospitalized in the Respiratory Department of 9 hospitals in Ningxia from April 2019 to April 2020 were selected.The general data questionnaire,the FRAIL scale(FRAIL),COPD assessment test(CAT),Barthel index(BI),mini nutritional assessment-short form(MNA-SF)and geriatric depression scale(GDS)were used for investigation and evaluation.Results The incidence rate of frailty in elderly patients with COPD complicated with dysphagia was 66.17%.There were statistical differences in frailty of elderly COPD patients with dysphagia with different ages,nutritional status,numbers of comorbidities,severity of disease,order of severity of COPD,activity of daily living(ADL)ability and depression status(P<0.05).Binary logistic regression analysis showed that age,order of severity of COPD,ADL ability and depression status were the influencing factors of frailty in elderly patients with COPD complicated with dysphagia(P<0.05).Conclusion The prevalence of frailty in elderly patients with COPD complicated with dysphagia is high.In clinical doctors should strengthen the evaluation of elderly patients with COPD complicated with dysphagia who are elderly,have severe COPD,low ADL and accompanied with depressive symptoms,and identify risk factors early to avoid and reduce negative events caused by frailty and improve the quality of life of patients.