社区老年衰弱与血清因子的相关性研究

  目的  了解社区老年衰弱情况，分析血清因子与老年衰弱的相关性，并给予社区医务人员相应的建议。  方法  选取2018年4—9月在上海市嘉定区安亭镇黄渡社区卫生服务中心进行健康体检的老年人375例作为研究对象。研究者自制一般资料调查问卷；血常规、肝肾功能等指标均从本社区老年人体检数据库导出；白细胞介素6、胰岛素生长因子1等指标由合作单位上海市中医老年医学研究所负责测定。采用有序多因素logistic回归分析老年衰弱与上述血清因子水平的相关性。  结果  (1) 375例老年人中，非衰弱期173例、衰弱前期188例、衰弱期14例。不同衰弱程度老年人的性别、年龄、文化程度、吸烟史、饮酒史比较，差异均有统计学意义(均P＜0.05)。(2)不同衰弱程度社区老年人血清生化指标中，仅血红蛋白组间比较差异有统计学意义(P＜0.05)。(3)不同衰弱程度社区老年人特殊血清生化指标的胰岛素生长因子、促卵泡激素、雌二醇比较，差异均有统计学意义(均P＜0.05)。(4)有序多因素logistic回归分析结果发现，血红蛋白、胰岛素生长因子、促卵泡激素、雌二醇等因子水平与衰弱发生无相关性。  结论  血清因子与社区老年衰弱的相关性受多种因素影响，社区全科医生应对社区老年人群早期进行衰弱的全方面综合评估。 

Correlation between frailty and related serum factors in elderly community

  Objective  To understand the situation of senile frailty in community, analyze the correlation between serum factors and senile frailty, and give corresponding suggestions to community medical staff.  Methods  A total of 375 elderly people who underwent physical examination in Huangdu Community Health Service Center, Anting Town, Jiading District, Shanghai from April to September 2018 were selected as the research subjects. The researchers made their own general data questionnaire.The indexes of blood routine and liver and kidney function were derived from the physical examination database of the elderly in this community. Interleukin-6 (IL-6), insulin growth factor 1 (IGF-1) and other indicators were measured by Shanghai Institute of Traditional Chinese Medicine. Ordered multifactor logistic regression was used to analyze the correlation between senile frailty and the levels of the above serum factors.  Results  (1) Among the 375 elderly patients, 173 were at non-frailty stage, 188 at pre-frailty stage and 14 at frailty stage. The gender, age, educational level, smoking history and drinking history of the elderly with different degrees of frailty had statistical significance (all P < 0.05). (2) Among the serum biochemical indexes of the elderly in the community with different degrees of frailty, only hemoglobin had the differences were statistically significant (P < 0.05). (3) The differences of insulin growth factor (IGF-1), follicle-stimulating hormone (FSH) and estradiol (E₂) in special serum biochemical indexes of the elderly in the community with different frailty levels were statistically significant (all P < 0.05). (4)The results of logistic regression analysis showed that the levels of hemoglobin (HB), insulin growth factor (IGF-1), follicle-stimulating hormone (FSH), estradiol (E₂) and other factors had no correlation with the occurrence of frailty.  Conclusion  The correlation between serum factors and community geriatric frailty is affected by many factors, so community general practitioners should conduct comprehensive assessment of community geriatric frailty in the early stage.