高龄住院患者血清学指标与衰弱程度相关性分析

章妙玉; 罗科学; 高燕飞; 李宏春; 钟玲玲

doi:10.16766/j.cnki.issn.1674-4152.001809

高龄住院患者血清学指标与衰弱程度相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.001809

浙江省立同德医院干部保健科，浙江杭州 310012

基金项目:

浙江省医药卫生科技计划项目 2020KY511

详细信息

通讯作者:
罗科学，E-mail：flyingsea521@126.com

中图分类号: R592 R446
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- 被引次数: 0
出版历程
- 收稿日期: 2020-04-29
- 网络出版日期: 2022-02-19

Analysis of the correlation between serum indexes and the degree of frailty in elderly inpatients

Department of Cadre Health Care, Tongde Hospital, Hangzhou, Zhejiang 310012, China

摘要

摘要: 目的分析血清25-羟基维生素D[25(OH)D]、白细胞介素10(IL-10)、D-二聚体(D-D)水平与高龄住院衰弱患者衰弱程度的相关性。方法选取浙江省立同德医院420例高龄住院患者作为研究对象，其中衰弱组47例，非衰弱组373例。比较衰弱组、非衰弱组，衰弱组中不同衰弱程度患者、再入院与未再入院患者血清25(OH)D、IL-10、D-D水平，分析高龄住院患者衰弱发生的影响因素，探讨血清各指标与衰弱程度的相关性及对高龄住院伴衰弱患者再入院的预测价值。结果年龄、住院时间、血清25(OH)D、IL-10、D-D均为高龄住院患者衰弱发生的重要危险因素(OR=4.847、5.887、0.580、4.820、5.120，均P＜0.05)；血清25(OH)D水平(r=-0.415)与高龄住院伴衰弱患者衰弱程度呈负相关性，IL-10(r=0.379)、D-D(r=0.392)水平与衰弱程度呈正相关性(均P＜0.05)；血清25(OH)D、IL-10、D-D联合预测高龄住院伴衰弱患者再入院的曲线下面积为0.844，敏感性为80.96%，特异性为80.77%。结论血清25(OH)D、IL-10、D-D水平异常表达与衰弱程度相关，三者联合可为预测高龄住院伴衰弱患者再入院提供循证指导。
- 高龄 /
- 住院 /
- 25-羟基维生素D /
- 白细胞介素10 /
- D-二聚体 /
- 衰弱程度
Abstract: Objective To analyze the correlation between serum 25-hydroxyvitamin D [25(OH)D], interleukin-10 (IL-10), D-dimer (D-D) levels and the degree of frailty in elderly hospitalized frail patients. Methods A total of 420 elderly inpatients in our hospital were selected as the research objects, including 47 in the frailty group and 373 in the non-frailty group. The serum 25(OH)D, IL-10 and D-D levels of patients with different degrees of debilitating and re-admitted and non-re-admitted patients were compared between the two groups. The influencing factors of the occurrence of frailty in elderly inpatients were analyzed, and the correlation between serum indexes and the degree of frailty and the predictive value of re-admission to elderly frail patients were discussed. Results Age, length of hospital stays, 25(OH)D, IL-10, and D-D were all important risk factors for frailty in elderly hospitalized patients (OR=4.847, 5.887, 0.580, 4.820, 5.120, all P < 0.05). Serum 25(OH)D level (r=-0.415) was negatively correlated with the degree of frailty in elderly hospitalized patients with frailty. IL-10 (r=0.379) and D-D (r=0.392) levels were positively correlated with the degree of frailty (P < 0.05). The area under the curve predicted by the combination of serum 25(OH)D, IL-10, and D-D for re-admission of elderly hospitalized patients with frailty was 0.844, the sensitivity was 80.96%, and the specificity was 80.77%. Conclusion The abnormal expression of serum 25(OH)D, IL-10 and D-D levels is related to the degree of frailty. The combination of the three can provide evidence-based guidance for predicting the re-admission of elderly hospitalized patients with frailty.
- Elderly /
- Hospitalization /
- 25-hydroxyvitamin D /
- Interleukin 10 /
- D-dimer /
- Degree of frailty

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图 1 血清25(OH)D、IL-10、D-D单一及联合指标预测价值

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表 1 2组高龄住院患者一般资料比较 [例(%)]

组别	例数	性别(男/女，例)	体重指数(x±s)	原发疾病类型
组别	例数	性别(男/女，例)	体重指数(x±s)	循环系统疾病	内分泌系统疾病	神经系统疾病	消化系统疾病	呼吸系统疾病	运动系统疾病
衰弱组	47	31/16	20.96±1.45	25(53.19)	10(21.28)	4(8.51)	3(6.38)	3(6.38)	2(4.26)
非衰弱组	373	246/127	21.07±1.19	198(53.08)	79(21.18)	31(8.31)	23(6.17)	24(6.43)	18(4.83)
统计量		<0.001^a	0.582^b	0.034^a
P值		0.999	0.561	0.999
注：^a为χ²值，^b为t值。

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表 2 2组高龄住院患者年龄、住院时间、FP评分、血清指标比较(x±s)

组别	例数	年龄(岁)	住院时间(d)	FP评分(分)	25(OH)D (ng/mL)	IL-10 (ng/L)	D-D (μg/L)
衰弱组	47	86.83±1.30	17.74±1.29	3.28±0.19	10.94±4.13	29.14±7.16	495.12±125.96
非衰弱组	373	82.61±1.25	10.46±1.63	1.50±0.22	15.17±6.58	23.01±5.14	257.42±92.84
t值		21.714	29.467	53.020	4.299	7.335	15.826
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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表 3 高龄住院患者衰弱发生有关影响因素的logistic回归分析

因素	B	SE	Wald χ²	P值	OR值	95% CI
年龄	1.578	0.351	20.222	＜0.001	4.847	2.629~8.937
住院时间	1.773	0.372	22.710	＜0.001	5.887	3.528~9.824
25(OH)D	-0.545	0.128	18.134	＜0.001	0.580	0.348~0.966
IL-10	1.573	0.345	20.782	＜0.001	4.820	2.765~8.402
D-D	1.633	0.369	19.587	＜0.001	5.120	2.628~9.974

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表 4 不同衰弱程度患者血清25(OH)D、IL-10、D-D水平比较(x±s)

衰弱程度	例数	25(OH)D (ng/mL)	IL-10(ng/L)	D-D(μg/L)
轻度	12	13.15±3.47	26.12±4.12	315.74±101.65
中度	19	10.78±2.78	28.95±3.25	489.26±127.83
重度	16	9.47±1.95	31.63±4.74	636.61±139.62
F值		6.271	6.451	22.217
P值		0.004	0.004	＜0.001

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表 5 血清25(OH)D、IL-10、D-D水平与衰弱程度的相关性

指标	r值	P值
25(OH)D	-0.415	＜0.001
IL-10	0.379	＜0.001
D-D	0.392	＜0.001

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表 6 再入院与未再入院高龄住院伴衰弱患者血清25(OH)D、IL-10、D-D水平比较(x±s)

组别	例数	25(OH)D (ng/mL)	IL-10(ng/L)	D-D(μg/L)
再入院	21	8.25±2.15	33.14±5.12	602.84±137.41
未再入院	26	13.11±5.62	25.91±4.78	408.12±115.34
t值		3.742	4.994	5.283
P值		0.001	＜0.001	＜0.001

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