老年人衰弱综合征与血压等心血管危险因素的相互关系

Association of frailty syndrome in elderly with high blood pressure and other potential cardiovascular risk factors

目的探讨动态血压与衰弱综合征患者心血管危险因素的关系。方法选择2018年11月~2021年9月在北部战区总医院干部病房住院的老年患者,最终纳入67名患者并分为3组[非衰弱组(n=23),衰弱前期组(n=31)和衰弱组(n=13)]。收集整理各组患者24 h动态血压监测(ambulatory blood pressure monitoring,ABPM)数据、腹围以及空腹血糖、血脂、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)等生化指标,并进行统计分析。结果与非衰弱组相比,衰弱组的腹围较大,HDL较低(均P<0.05)。与非衰弱组相比,衰弱前期组SBP(24 h)数值升高(P<0.05),DBP(24 h)数值升高(P<0.05),SBP(清醒)数值升高(P<0.05),DBP(清醒)数值升高(P<0.05),SBP(睡眠)数值升高(P<0.05),DBP(睡眠)数值升高(P<0.05);衰弱组SBP(24 h)数值升高(P<0.01),DBP(24 h)数值升高(P<0.01),SBP(清醒)数值升高(P<0.01),DBP(清醒)数值升高(P<0.01),SBP(睡眠)数值升高(P<0.01),DBP(睡眠)数值升高(P<0.01)。与衰弱前期组比较,衰弱组SBP(24 h)数值升高(P<0.05),DBP(24 h)数值升高(P<0.05),SBP(清醒)数值升高(P<0.05),DBP(清醒)数值未见明显变化,SBP(睡眠)数值升高(P<0.05),DBP(睡眠)数值未见明显变化.结论衰弱综合征与较高的血压、较大的腹围和较低的HDL相关,并可能存在肥胖、肌肉减少症,衰弱评估对住院老年患者的病情综合评估和治疗策略的选择具有重要意义。

AIM To assess the cardiovascular risk factors in patients with frailty syndrome with emphasis on blood pressure(BP),as compared with those in individuals without frailty or with prefrailty.METHODS A total of 67 elderly patients hospitalized in General Hospital of Northern Theater Command from November 2018 to September 2021 were included and divided into three groups:nonfrailty group(n=23),pre-frailty group(n=31)and frailty group(n=13).The 24-hour ambulatory blood pressure monitoring(ABPM)data,abdominal circumference,fasting blood glucose,blood lipid,low density lipoprotein(LDL),high density lipoprotein(HDL)and other biochemical indexes were collected and analyzed.Anthropometric and BP measurements were obtained in the office.Fasting glucose and plasma lipids were collected.Data were analyzed by linear fixed effects model and ANOVA.RESULTS Compared with the non debilitating group,the debilitating group had larger abdominal circumference and lower HDL(all P<0.05).Comparison of blood pressure levels in each group compared with the non debilitating group,SBP(24 h)increased(P<0.05),DBP(24 h)increased(P<0.05),SBP(awake)increased(P<0.05),DBP(awake)increased(P<0.05),SBP(sleep)increased(P<0.05)and DBP(sleep)increased(P<0.05)in the pre debilitating group.Compared with the non debilitating group,the values of SBP(24 h),DBP(24 h),SBP(awake)(P<0.01),DBP(awake)(P<0.01),SBP(sleep)(P<0.01)and DBP(sleep)(P<0.01)in the debilitating group increased.Compared with the pre debilitating group,the value of SBP(24 h)increased(P<0.05),DBP(24 h)increased(P<0.05),SBP(awake)increased(P<0.05),DBP(awake)did not change significantly,SBP(sleep)increased(P<0.05),DBP(sleep)did not change significantly.CONCLUSION Frailty syndrome is associated with higher blood pressure,larger abdominal circumference and lower HDL,and may have obesity and sarcopenia.The evaluation of asthenia is of great significance for the comprehensive evaluation of the condition and the choice of treatment strategies of hospitalized elderly patients.