武汉市某医院老年慢性阻塞性肺疾病住院患者发生衰弱现状及其影响因素分析

摘要：目的 调查武汉市某医院老年慢性阻塞性肺疾病（COPD）住院患者发生衰弱现状，并分析其影响因素。方法 采用便利抽样法选取2021年1月-2022年12月我院住院的260例老年COPD住院患者。采用自制一般资料问卷对患者开展调查；使用临床衰弱量表（Fried）对患者的衰弱状况进行评估；采用全自动血液分析仪对血红蛋白的水平进行检测；采用化学发光免疫法对25-羟基维生素D（25-OH-D）的水平进行检测；采用噶庖呶椒ǘ园紫赴樗�-6（IL-6）的水平进行检测；单因素及多因素Logistic回归分析影响老年COPD住院患者发生衰弱的因素。结果 本研究对武汉市某医院老年COPD住院患者一共发出260份调查问券，收回260份，有效率为100.00%。260例患者中，发生衰弱的有67例，发生率为25.77%（67/260）；其中性别、年龄、吸烟、锻炼习惯、营养状态比较均有统计学意义（P<0.05）；衰弱组患者的血红蛋白、25-OH-D水平显著低于未衰弱组，IL-6水平显著高于为衰弱组（P＜0.05）；根据Logistic回归分析得知性别（OR=3.174，95%CI：1.415-7.117）、年龄（OR=1.556，95%CI：1.049-2.307）、吸烟（OR=3.162，95%CI：1.337-7.476）、锻炼习惯（OR=1.735，95%CI：1.103-2.729）、血红蛋白低表达（OR=1.314，95%CI：1.014-1.701）、25-OH-D低表达（OR=1.974，95%CI：1.073-3.631）、IL-6高表达（OR=2.173，95%CI：1.198-3.943）是老年COPD住院患者发生衰弱的危险因素（P＜0.05）。结论 武汉市某医院老年COPD住院患者发生衰弱的发生率较高，性别、年龄、吸烟、锻炼习惯、营养状态、血红蛋白、25-OH-D、IL-6水平均有影响，临床上应进行合理的干预，从而减少衰弱的发生。

Analysis of the prevalence and influencing factors of frailty in elderly patients with chronic obstructive pulmonary disease in a hospital in Wuhan City

Abstract: Objective To investigate the prevalence of frailty in elderly patients with chronic obstructive pulmonary disease (COPD) in a hospital in Wuhan, and analyze its influencing factors. Methods A convenient sampling method was applied to select 260 elderly patients with COPD hospitalized in our hospital from January 2021 to December 2022. A self-made general information questionnaire was used to investigate patients; the patient''s frailty condition was evaluated using the Clinical Frailty Scale (Fried); a fully automated blood analyzer was applied to detect the level of hemoglobin; chemiluminescence immunoassay was applied to detect the level of 25-hydroxyvitamin D (25-OH-D); enzyme linked immunosorbent assay was applied to detect the level of interleukin-6 (IL-6); univariate and multivariate logistic regression analyses were applied to analyze the factors that affected the onset of frailty in elderly hospitalized patients with COPD. Results A total of 260 questionnaires were issued to elderly patients with COPD in a hospital in Wuhan, and 260 questionnaires were retrieved, with an effective rate of 100.00%. Of the 260 patients, 67 had frailty, with an incidence of 25.77% (67/260); there were significant differences in gender, age, smoking, exercise habits, and nutritional status (P<0.05); the levels of hemoglobin and 25-OH-D in the frailty group were significantly lower than those in the non frailty group, while the level of IL-6 was significantly higher than that in the frailty group (P<0.05); according to Logistic regression analysis, gender (OR=3.174, 95% CI: 1.415-7.117), age (OR=1.556, 95% CI: 1.049-2.307), smoking (OR=3.162, 95% CI: 1.337-7.476), exercise habits (OR=1.735, 95% CI: 1.103-2.729), low hemoglobin expression (OR=1.314, 95% CI: 1.014-1.701), low 25-OH-D expression (OR=1.974, 95% CI: 1.073-3.631), and high IL-6 expression (OR=2.173, 95% CI: 1.198-3.943) were risk factors for frailty in elderly hospitalized patients with COPD (P<0.05). Conclusion The incidence of frailty among elderly COPD inpatients in a hospital in Wuhan is high, and gender, age, smoking, exercise habits, nutritional status, hemoglobin, 25-OH-D, and IL-6 levels have an impact. Reasonable clinical intervention should be carried out to reduce the incidence of frailty.