老年人衰弱与颈动脉内膜中层厚度的相关性研究

Correlation between frailty and carotid intima-media thickness in the elderly

目的探讨老年人衰弱与颈动脉内膜中层厚度(cIMT)的相关性。方法采用目的抽样法,选取2020年6~12月在海南医学院第二附属医院进行体检的457例≥65岁老年人为调查对象。采用自行设计的一般资料调查表和衰弱筛查量表(FRAIL量表)进行问卷调查,测量受试者的cIMT,检测血清生化指标。根据FRAIL评分,所有研究对象分为衰弱组(FRAIL评分≥3分)和非衰弱组(FRAIL评分<3分)。采用单因素分析、多元线性回归分析、ROC曲线探讨老年人衰弱与cIMT的关系。结果老年人衰弱发生率为29.76%。2组老年人年龄、BMI、SBP、查尔森并发症指数(CCI)评分、cIMT和估算肾小球滤过率(eGFR)差异有统计学意义(P<0.01)。多元线性回归分析结果显示,年龄、CCI评分、cIMT和eGFR与老年人FRAIL评分独立相关(P<0.05)。ROC曲线分析结果显示,cIMT预测老年人衰弱的AUC(0.812)明显大于年龄(0.667)、CCI评分(0.724)和eGFR(0.689),差异均有统计学意义(均P<0.05);当cIMT截点为1.089 mm时,其预测老年人衰弱的灵敏度为69.12%,特异度为87.85%。结论老年人衰弱具有较高的发生率,并与年龄、CCI评分、cIMT和eGFR密切相关,cIMT可帮助早期识别老年衰弱高危人群。

Objective To investigate the correlation between frailty and carotid intima-media thickness(cIMT)in the elderly.Methods By using purposive sampling method,a totall of 457 elderly people aged 65 years and over who underwent physical examination in the Second Affiliated Hospital of Hainan Medical University during June to December 2020 were selected as the subjects.All the subjects received an interviewer-administered questionnaire survey using self-designed general data questionnaire and FRAIL scale.And the levels of cIMT and serum biochemical indexes of the subjects were measured.According to FRAIL scale score,the subjects were divided into frailty group(FRAIL scale score≥3)and non-frailty group(FRAIL scale score<3).Univariate analysis,multiple linear regression analysis and receiver operating characteristic(ROC)curve were used to explore the association between frailty and cIMT in the elderly.Results The prevalence rate of frailty in the elderly was 29.76%.Age,the levels of BMI,systolic blood pressure(SBP),Charlson complication index(CCI),cIMT and estimated glomerular filtration rate(eGFR)were significantly different between the two groups(P<0.01).Multiple linear regression analysis showed that age,CCI score,cIMT and eGFR were the independent influencing factors of FRAIL scale score in the elderly(P<0.05 or P<0.01).ROC curve analysis showed that the area under curve of cIMT for predicting frailty was significantly greater than that of age(0.812 VS 0.667,Z=3.644,P<0.001),CCI score(0.812 VS 0.724,Z=2.573,P=0.010)and eGFR(0.812 VS 0.689,Z=3.653,P<0.001).The optimal cut-off value of cIMT was 1.089 mm,which displayed a sensitivity of 69.12%and a specificity of 87.85%for the prediction of frailty in the elderly.Conclusions The elderly people have higher prevalence rate of frailty.Age,CCI score,cIMT and eGFR are closely related to frailty.cIMT may be used for the evaluation of frailty status in the elderly.