老年缺血性脑卒中患者衰弱的影响因素及其与营养状态和认知功能的关系

Influence factors for frailty in elderly patients with ischemic stroke and their relationship with nutritional status and cognitive function

中文关键词: 老年  缺血性脑卒中  衰弱  营养状态  认知功能

英文关键词: elderly  ischemic stroke  frailty  nutritional status  cognitive function

中文摘要:

      目的 探讨老年缺血性脑卒中(IS)患者衰弱的影响因素及其与营养状态和认知功能的关系.方法 回顾性选取2019 年1 月—2021 年1 月于江苏连云港市第二人民医院收治的146 例老年IS患者作为研究对象,根据患者是否发生衰弱分为衰弱组和非衰弱组.比较2 组临床资料、营养状态和认知功能;采用Pearson检验患者衰弱与营养状态和认知功能的相关性,采用二元Logistic回归分析老年IS患者衰弱的影响因素.结果 本研究共纳入146 例老年IS患者,41 例患者发生衰弱,衰弱发生率为28.05%;衰弱组MNA-SF评分、MMSE评分均低于非衰弱组(t =3.454;t =5.161,均P＜0.05);Pearson相关性分析显示,FRAIL评分与MNA-SF评分、MMSE评分均呈负相关(r =-0.456;r =-0.503,均P＜0.05),MNA-SF评分与MMSE评分均呈正相关(r =0.488,P＜0.05);衰弱组年龄≥75 岁、肾功能不全、入院时NIHSS评分≥15 分、HAMD评分≥7 分、MNA-SF评分＜8 分、MMSE评分＜25 分占比均高于非衰弱组(P＜0.05);多因素Logistic分析发现,年龄≥75 岁(OR =2.700,P =0.045)、HAMD评分≥7 分(OR =4.399,P =0.002)、白蛋白＜35 g/L(OR =5.057,P =0.001)、MNA-SF评分＜8 分(OR =3.433,P =0.015)、MMSE评分＜25 分(OR =4.155,P =0.013)均为影响老年IS患者衰弱的独立危险因素(P＜0.05).结论 老年IS患者衰弱发生率较高,其可能与营养不良、认知功能障碍具有一定的相关性.

英文摘要:

      Objective To explore the influence factors for frailty and its relationship with nutritional status and cognitive function in elderly patients with ischemic stroke(IS).Methods A total of 146 elderly IS patients admitted to Second People's Hospital of Lianyungang City,Jiangsu Province from January 2019 to January 2021 were retrospectively selected as the study subjects.According to presence or absence of frailty,they were divided into frailty group and non-frailty group.The clinical data,nutritional status and cognitive function of the two groups were compared.The correlation between frailty and nutritional status and cognitive function was analyzed by Pearson correlation analysis,and the influencing factors for frailty were analyzed by logistic regression analysis.Results A total of 146 elderly IS patients were included,of which 41 ones experienced frailty,with an incidence of 28.05%.The scores of MNA-SF and MMSE of the frailty group were lower than those of the non-frailty group(t =3.454;t =5.161,P＜0.05).Pearson correlation analysis showed that FRAIL score was negatively correlated with MNA-SF and MMSE scores(r =-0.456;r =-0.503,P＜0.05),while MNA-SF score was positively correlated with MMSE score(r =0.488,P＜0.05).The proportion of patients in the frail group with age≥75 years old,renal insufficiency,NIHSS score≥15 points at admission,HAMD score≥7 points,MNA-SF score＜8 points,MMSE score＜25 points were high-er than those in the non-frail group(P＜0.05).Multivariate Logistic analysis showed that age≥75 years(OR = 2.700,P =0.045),HAMD score≥7 points(OR =4.399,P =0.002),albumin＜35 g/L(OR =5.057,P =0.001),MNA-SF score＜8 points(OR =3.433,P =0.015)and MMSE score＜25 points(OR =4.155,P =0.013)were independent risk fac-tors for frailty in elderly IS patients(P＜0.05).Conclusion The incidence of frailty is higher in elderly IS patients,which may be related to malnutrition and cognitive dysfunction.