握力下降的老年住院患者临床特征及握力下降的危险因素

Clinical Characteristics of Elderly Hospitalized Patients with Low Grip Strength and Risk:Factors of Low Grip Strength

目的探讨握力下降的老年住院患者的临床特征及握力下降危险因素。方法选取2019年9月至2021年6月在郑州大学第一附属医院老年科住院的285例老年患者,收集其一般资料及临床指标数据,根据男性握力<28kg,女性握力<18kg,分为握力正常组(144例)和握力下降组(141例)。根据年龄对两组进行1∶1倾向性得分匹配(PSM),共成功匹配103对。比较两组患者一般情况及各项临床指标差异,采用多因素logistic回归分析老年住院患者握力下降的相关危险因素。结果经PSM调整年龄后,与握力正常组相比,握力下降组体质量指数(BMI)、血红蛋白、白蛋白、前白蛋白、谷丙转氨酶及患有高血压的比率均较低(P<0.05),总胆固醇、血小板计数、C反应蛋白、低密度脂蛋白及患有痴呆的比率均升高(P<0.05)。多因素logistic回归提示年龄[OR(95%CI)为1.278(1.179~1.385),P<0.001]、总胆固醇[OR(95%CI)为2.476(1.670~3.661),P<0.001]、血小板计数[OR(95%CI)为1.008(1.002~1.013),P=0.007]及患有痴呆[OR(95%CI)为3.398(1.200~9.626),P=0.021]为握力下降的危险因素,血红蛋白[OR(95%CI)为0.947(0.925~0.971),P<0.001]及患有高血压[OR(95%CI)为0.143(0.065~0.313),P<0.001]为握力下降的保护因素。结论老龄化、高水平的胆固醇及患有痴呆可能促进握力下降的发生,改善血红蛋白水平可能有助于改善握力下降。

Objective To explore the clinical characteristics of elderly hospitalized patients with low grip strength and risk factors of low grip strength.Methods A total of 285 elderly hospitalized patients in the Geriatrics Department of the First Affiliated Hospital of ZhengZhou University from September 2019 to June 2021 were selected to collect their general information and clinical index data.According to male grip strength<28 kg and female grip strength<18 kg,they were divided into normal grip strength group(144 cases)and low grip strength group(141 cases).The age of the two groups was matched by 11 propensity score matching(PSM),and a total of 103 pairs were successfully matched.The differences of general information and clinical indicators in the two groups were compared.Binary logistic regression was used to analyze the correlation and risk factors of grip strength decline in elderly inpatients.Results After age adjustment by PSM,compared with the normal grip strength group,the incidence of body mass index(BMI),hemoglobin,albumin,prealbumin,alanine aminotransferase and the prevalence of hypertension were decreased in the low grip strength group(P<0.05),and total cholesterol,platelet,C-reactive protein,low density lipoprotein and the prevalence of dementia were increased in the low grip strength group(P<0.05).Logistic regression indicated age[OR(95%CI):1.278(1.179-1.385),P<0.001],total cholesterol OR(95%CI):2.476(1.670-3.661),P<0.001)],platelet[OR(95%CI):1.008(1.002-1.013),P=0.007)]and dementia[OR(95%CI):3.398(1.200-9.626),P=0.021]were the risk factors for lowgrip strength,and hemoglobin[OR(95%CI):0.947(0.925-0.971),P<0.001],and hypertension[OR(95%CI):0.143(0.065-0.313),P<0.001]were protective factors of low grip strength(P<0.05).Conclusion Aging,high levels of cholesterol,and with dementia may increase the occurrence of low grip strength,improve hemoglobin level may help to improve low grip strength.