高密度脂蛋白胆固醇对老年气虚证患者衰弱的影响

The effect of high-density lipoprotein cholesterol on frailty in elderly patients with Qi-deficiency syndrom

目的探讨气虚证与衰弱的相关性及高密度脂蛋白胆固醇对老年气虚证患者衰弱的影响。方法选取2020年10月至2021年1月于首都医科大学附属北京中医医院和河北医科大学附属燕达医院就诊的老年(年龄≥60岁)气虚证患者,根据衰弱量表将其分为衰弱组、衰弱前期组和无衰弱组。记录患者气虚证积分、老年综合评估项目、血脂检测结果。分析高密度脂蛋白胆固醇(HDL-C)对衰弱的影响。结果本研究共纳入277例老年气虚证患者,其中衰弱组60例、衰弱前期组90例、无衰弱组127例。衰弱组、衰弱前期组年龄和气虚证积分均高于无衰弱组,且衰弱组高于衰弱前期组;衰弱组日常生活活动能力(ADL)量表评分、工具性ADL量表评分、运动时间均低于/短于衰弱前期组和无衰弱组,差异均有统计学意义(均P<0.05)。衰弱组和衰弱前期组抑郁、多重用药比例均高于无衰弱组,差异均有统计学意义(均P<0.001)。衰弱组和衰弱前期组总胆固醇、低密度脂蛋白胆固醇水平均低于无衰弱组,衰弱组HDL-C水平低于无衰弱组和衰弱前期组[(1.3±0.3)mmol/L比(1.4±0.5)、(1.4±0.4)mmol/L],差异均有统计学意义(均P<0.05)。Spearman相关性分析结果显示,气虚证积分与衰弱、抑郁均显著相关,与运动时间、ADL量表评分、HDL-C水平均呈负相关(均P<0.05)。多因素Logistic回归分析结果显示,HDL-C是老年气虚证患者衰弱的独立影响因素(P<0.05)。结论气虚证积分与衰弱显著相关,HDL-C是老年气虚证患者衰弱的独立影响因素。

Objective To explore the correlation between Qi-deficiency syndrome and frailty and the influence of high-density lipoprotein cholesterol(HDL-C)on frailty in elderly patients with Qi-deficiency syndrome.Methods From October 2020 to January 2021,elderly patients(aged≥60 years)with Qi-deficiency syndrome admitted to Beijing Hospital of Traditional Chinese Medicine,Capital Medical University and Yanda Hospital,Hebei Medical University were selected.According to frailty scale,they were divided into frailty group,pre-frailty group and non-frailty group.The Qi-deficiency syndrome score,comprehensive geriatric assessment and blood lipid detection of patients were recorded.The influence of HDL-C on frailty was analyzed.Results There were 277 cases of elderly patients with Qi-deficiency syndrome enrolled in this study,including 60 cases in frailty group,90 cases in pre-frailty group and 127 cases in non-frailty group.The age and Qi-deficiency syndrome score of frailty group and pre-frailty group were higher than those of non-frailty group,and those of frailty group were higher than those of pre-frailty group;activity of daily living(ADL)scale score,instrumental ADL scale score and exercise time of frailty group were lower/shorter that those of pre-frailty group and non-frailty group(all P<0.05).Rates of depression and multiple drug use of frailty group and pre-frailty group were higher than those of non-frailty group(both P<0.001).Levels of total cholesterol and low-density lipoprotein cholesterol of frailty group and pre-frailty group were lower than those of non-frailty group,and the level of HDL-C of frailty group was lower than that of pre-frailty group and non-frailty group[(1.3±0.3)mmol/L vs(1.4±0.5),(1.4±0.4)mmol/L](all P<0.05).Spearman correlation analysis showed that Qi-deficiency syndrome score was significantly correlated with frailty and depression,and was negatively correlated with exercise time,ADL scale score and HDL-C level(all P<0.05).Multivariate Logistic regression analysis showed that HDL-C was an independent influencing factor for frailty in elderly patients with Qi-deficiency syndrome(P<0.05).Conclusions There is a significant correlation between Qi-deficiency syndrome score and frailty.HDL-C is an independent influencing factor of frailty in elderly patients with Qi-deficiency syndrome.