摘要
背景当前关于慢性阻塞性肺疾病(以下简称慢阻肺)的研究多着重于肺部本身,而关于慢阻肺肺外表现的研究依然缺乏,国内外多项研究显示慢阻肺与老年综合征密切相关,但尚未得到进一步证实。目的调查云南省多家医院近3年老年住院患者慢阻肺的患病现状,并从老年综合征角度探讨老年慢阻肺的影响因素。方法选取2018年9月至2021年6月云南省多家医院新入院老年(≥60岁)患者2182例为研究对象,根据患者是否患有慢阻肺分为慢阻肺组和非慢阻肺组。采用云南省第一人民医院老年医学科自主研发的“老年综合评估系统”软件平台对患者进行一般资料收集,并利用其中的量表对患者进行老年综合评估,内容包括采用老年抑郁评估量表(GDS-15)评估焦虑抑郁状态、阿森斯失眠量表(AIS)评估失眠情况、家庭关怀度指数问卷(PAGAR)评估家庭支持情况、Morse量表评估跌倒风险、简易智力状态检查量表(MMSE)评估认知功能、微型营养评估量表评估营养状况、基本生活活动能力(BADL)量表评估日常生活能力、Fried量表评估衰弱状况、吞咽功能评估量表评估吞咽功能(呛咳)、尿失禁问卷表简表(ICI-Q-SF)评估尿失禁情况、RomaⅢ量表评估便秘情况、视觉模拟法评估疼痛情况、1年内有无跌倒情况。老年住院患者慢阻肺的影响因素探讨采用二元Logistic回归分析。结果非慢阻肺组1558例(71.4%),慢阻肺组624例(28.6%);二元Logistic回归分析结果显示,年龄75~<85岁、≥85岁、男性、焦虑抑郁状态、潜在营养不良、营养不良、衰弱前期、衰弱是老年慢阻肺的影响因素(P<0.05)。结论≥60岁的老年住院患者慢阻肺患病率较高,并与老年综合征密切相关。
Background Current studies on chronic obstructive pulmonary disease(hereinafter referred to as COPD)mostly focus on the lung itself,while studies on the extrapulmonary manifestations of COPD are still lacking.Many studies in China and at abroad have shown that COPD is closely related to geriatric syndrome,but it has not been further confirmed.Objective To investigate the prevalence of COPD in senile inpatients in several hospitals in Yunnan Province in the past three years,and to explore the influencing factors of elderly COPD from the aspect of geriatric syndrome.Methods A total of 2182 newly admitted elderly patients(≥60 years old)in several hospitals of Yunnan Province from September 2018 to June 2021 were selected as the research objects and divided into COPD group and non-COPD group according to whether the patients had COPD.The software platform of"Comprehensive Geriatric Assessment System"independently developed by the Geriatrics Department of the First People's Hospital of Yunnan Province was used to collect general data from the patients.At the same time,the scales in the system were used to conduct a comprehensive geriatric evaluation of the patients,including the assessment of anxiety and depression by 15-item geriatric depression scale(GDS-15),the assessment of insomnia situation by athens insomnia scale(AIS),the assessment of family support by PAGAR scale,the assessment of fall risk by Morse fall scale,the assessment of cognitive function by mini-mental state examination(MMSE),the assessment of nutrition status by mini nutritional assessment scale,the assessment of the patients'daily living ability by the basic activities of daily living(BADL)scale,the assessment of frailty state by the Fried Scale,the assessment of swallowing(choking)by swallowing function assessment scale,the assessment of urinary incontinence by incontinence questionnaire simple form(ICI-Q-SF),the assessment of constipation by Roma Ⅲ scale,the assessment of pain by visual analogue scale(VAS).The influencing factors of COPD in the elderly hospitalized patients were analyzed by binary Logistic regression.Results There were 1558 cases(71.4%)in the non-COPD group and 624 cases(28.6%)in the COPD group.The results of binary Logistic regression analysis showed that age≥75 and<85 years,age≥85 years old,male,anxiety and depression,potential malnutrition,malnutrition,prefrailty,frailty were independent influencing factors of COPD(P<0.05).Conclusion Elderly hospitalized patients aged≥60 years have a higher prevalence of COPD and are closely associated with geriatric syndrome.
作者
戴靖榕
李婕
何旭
李杨
李燕
DAI Jingrong;LI Jie;HE Xu;LI Yang;LI Yan(Medical School,Kunming University of Science and Technology,Kunming 650500,China;Department of Geriatrics,Yunnan First People's Hospital/Yunnan Branch of National Clinical Research Center for Geriatric Diseases(West China Hospital)/Collaborative Innovation Cooperative Unit of National Clinical Research Center for Geriatric Diseases(Beijing Hospital)/Yunnan Provincial Clinical Research Center for Geriatric Diseases/Dong Birong Expert Workstation,Kunming 650032,China)
出处
《中国全科医学》
CAS
北大核心
2022年第11期1320-1326,共7页
Chinese General Practice
基金
国家自然科学基金资助项目(81760109)
国家重点研发计划(2018YFC2002103)
云南省老年疾病临床医学研究中心项目(202102AA310069)——老年共病诊疗及临床转化研究
云南省董碧蓉专家工作站(202105AF150032)
云南省临床医学开发项目(2019LCZXKF-NM08,2021LCZXXF-NM09)
云南省医疗卫生单位内设研究机构科研项目(2017NS221,2017NS222,2018NS0241)。