基于多因素Logistic回归模型对老年肌少症合并下肢动脉硬化闭塞症的预测价值及多种组合运动训练的应用效果

Predictive value of multivariate Logistic regression model for arteriosclerosis obliterans in elderly patients with sarcopenia and the effect of a variety of combined exercise training

目的探讨老年肌少症患者合并下肢动脉硬化闭塞症(arteriosclerosis obliterans,ASO)的影响因素及多种组合运动训练的疗效观察。方法将2020年5月至2023年5月在石家庄市第三医院接受治疗的326例老年肌少症患者作为研究对象,根据患者是否合并ASO,分为ASO组(136例)和非ASO组(190例)。筛选老年肌少症患者合并ASO的影响因素。建立合并ASO风险预测模型并验证。将ASO组中接受常规训练的患者设为对照组(74例);在常规训练基础上接受多种组合运动训练的患者设为观察组(62例)。匹配后,比较两组训练前后的6 min总步行距离、跛行距离、踝肱指数和改良Barthel指数。结果高血脂、糖尿病、冠心病、肾功能不全、糖化血红蛋白A1c(hemoglobin A1c,HbA1c)和低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)水平是患者合并ASO的独立危险因素(P<0.05)。校准曲线结果均显示多因素Logistic回归模型具有较好的准确性。训练后,观察组患者6 min总步行距离、跛行距离、踝肱指数和改良Barthel指数改善明显。结论高血脂、糖尿病、冠心病、肾功能不全、HbA1c和LDL-C水平是老年肌少症患者合并ASO的独立危险因素。多种组合运动训练疗效更好。

Objective To explore the influencing factors of elderly patients with sarcopenia combined with lower limb arteriosclerosis obliterans(ASO)and observe the therapeutic effects of various combinations of exercise training.Methods A total of 326 elderly patients with sarcopenia treated in the Third Hospital of Shijiazhuang from May 2020 to May 2023 were divided into ASO group(136 cases)and non-ASO group(190 cases)according to whether the patients were combined with ASO.The influencing factors of ASO in elderly patients with sarcopenia were screened.The combined ASO risk prediction model was established and verified.Patients receiving routine training in ASO group were set as control group(74 cases).The observation group(62 cases)included patients who received multiple combination exercise training on the basis of routine training.After matching,6-min walk distance,limp distance,ankle brachial index,and modified Barthel index before and after training were compared between the two groups.Results Hyperlipidemia,diabetes,coronary heart disease,renal insufficiency,hemoglobin A1c(HbA1c)and low-density lipoprotein cholesterol(LDL-C)levels were independent risk factors for patients with ASO(P<0.05).The calibration curve results show that the multivariate Logistic regression model has good accuracy.After training,the observation group of multiple exercise showed significant improvement in 6-min walk distance,limp distance,ankle brachial index,and modified Barthel index.Conclusion Hyperlipidemia,diabetes,coronary heart disease,renal insufficiency,HbA1c and LDL-C levels are independent risk factors for ASO in elderly patients with sarcoperia.Multiple combinations of exercise training effect is better.