老年维持性血液透析患者衰弱变化轨迹及影响因素分析

Trajectory of frailty and its influencing factors in elderly patients on maintenance hemodialysis therapy

目的分析老年维持性血液透析患者衰弱变化轨迹及其影响因素。方法以便利抽样法选取扬州市3所医院的220例老年维持性血液透析患者为研究对象,采用Fried衰弱表型于基线、6个月、12个月、24个月对患者进行衰弱评分,通过潜类别增长模型识别衰弱变化轨迹的潜在类别,logistic回归分析影响因素。结果老年维持性血液透析患者衰弱变化轨迹可分为衰弱持续低水平组(29.5%)、衰弱缓慢上升组(65.5%)和衰弱持续高水平组(5.0%)。logistic回归分析显示,年龄、糖尿病史、睡眠障碍和血清白蛋白水平是衰弱变化轨迹分类的影响因素(均P<0.05)。结论老年维持性血液透析患者衰弱变化存在群体异质性,应依据影响因素实施针对性干预。

Objective To explore the potential categories and influencing factors of frailty trajectory in elderly patients on maintenance hemodialysis(MHD)therapy.Methods By using convenience sampling method,elderly MHD patients from three hospitals in Yangzhou were selected.The frailty scores of patients were assessed with the Fried Frailty Phenotype at baseline,6 months,12 months and 24 months later.The potential categories of frailty trajectory were identified by the latent class growth model,and the influencing factors were analyzed by logistic regression analysis.Results The trajectory of frailty in elderly MHD patients could be divided into 3 groups:the group with sustained low level of frailty(29.5%),the group with slow increase of frailty(65.5%)and the group with sustained high level of frailty(5.0%).Logistic regression analysis showed that,age,diabetes history,sleep disorder and serum albumin level were influencing factors of the frailty trajectory(all P<0.05).Conclusion The frailty changes among elderly MHD patients have population based heterogeneity.Intervention measures should be taken in pursuant to the influencing factors.