老年慢性心力衰竭病人衰弱综合征临床特点及相关危险因素分析

Analysis of the clinical characteristics and risk factors of frailty syndrome in elderly patients with chronic heart failure

目的:分析老年慢性心力衰竭(CHF)病人衰弱综合征临床特征及相关危险因素。方法:选择CHF病人为研究对象,采用调查问卷及查阅病历资料的方法,分析184例病人衰弱综合征临床特征及相关危险因素。结果:184例老年CHF病人中,发生衰弱综合征66例,发生率35.87%(66/184)。衰弱综合征组女性、年龄、初中及以下文化程度、独居、美国纽约心脏病协会分级(NYHA分级)(Ⅲ级+Ⅳ级)、合并疾病(2~7种)、肌酐高于非衰弱综合征组,血红蛋白、白蛋白、左心室射血分数低于非衰弱综合征组(P<0.05~P<0.01);多因素logistic回归分析结果显示,年龄、合并疾病数量、血红蛋白、肌酐、左心室射血分数是老年CHF病人衰弱综合征的独立影响因素(P<0.05~P<0.01)。结论:老年CHF病人伴发衰弱综合征风险较高,受多种因素影响,应加强对高龄、合并多种疾病等老年CHF病人的管理干预,以减少衰弱综合征的发生。

Objective:To analyze the clinical characteristics and related risk factors of frailty syndrome in elderly patients with chronic heart failure(CHF).Methods:A total of 184 patients with frailty syndrome from January 2017 to March 2019 were selected as the study object.The clinical characteristics and related risk factors of frailty syndrome were analyzed by the questionnaires and medical records.Results:Among 184 elderly patients with CHF,the frailty syndrome in 66 cases were found,and the incidence rate of which was 35.87%(66/184).The female,age,junior high school education or below,solitary and gradeⅢ+Ⅳof the New York Heart Association(NYHA classification),complicated diseases(2-7 kinds)and creatinine level in frailty syndrome group were higher than those in non-frailty syndrome group,and the levels of hemoglobin,albumin and left ventricular ejection fraction in frailty syndrome group were lower than those in non-frailty syndrome group(P<0.05 to P<0.01).The results of logistic multivariate regression analysis showed that the age,number of complicated diseases,and levels of hemoglobin,albumin and left ventricular ejection fraction were the independent influencing factors of frailty syndrome in elderly CHF patients(P<0.05 to P<0.01).Conclusions:The risk of frailty syndrome in elderly CHF patients is high,and whcih can be affected by many factors.The management intervention should be strengthened for elderly CHF patients with advanced age and multiple diseases to reduce the occurrence of frailty syndrome.