75岁以上经皮冠状动脉介入治疗术后患者衰弱现状及影响因素研究

doi:10.3761/j.issn.0254-1769.2025.13.009

摘要/Abstract

摘要：

目的评估75岁以上行经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）术后患者的衰弱现状及危险因素，为改善、延缓其衰弱状态提供参考。方法于2024年3月—8月，采用便利抽样法，选取北京市某三级甲等心血管病专科医院行PCI治疗的75岁以上患者作为调查对象，采用自行设计的一般资料调查表收集患者相关信息，于术后至出院前分别使用Fried衰弱表型、katz指数、工具性日常生活活动能力量表、Charlson共病指数、Morse跌倒评估量表、微型营养评定简表、简版老年抑郁量表进行综合评估。采用单因素及多因素Logistic回归分析PCI术后患者合并衰弱的影响因素。结果最终纳入患者278例，PCI术后衰弱发生率为52.16%，按照Fried衰弱表型评分分为非衰弱组和衰弱组，单因素分析显示，两组年龄、性别、血红蛋白、N末端脑钠肽前体、左心室射血分数、工具性日常生活活动能力量表得分、是否独居、营养状况、跌倒风险、抑郁程度等方面的比较，差异具有统计学意义（均P<0.05）。多因素Logistic回归分析显示，年龄、工具性日常生活活动能力量表得分、跌倒风险、营养状况、抑郁程度是衰弱的影响因素，OR值分别为1.167、0.575、1.597、0.399、3.610（均P<0.05）。结论 75岁以上PCI术后患者衰弱发生率较高，其影响因素较多，临床医护人员要重视对这类患者的长期管理，结合老年人生理、心理及社会情况等进行综合干预。

关键词: 老年人, 冠心病, 经皮冠状动脉介入治疗, 衰弱, 影响因素分析, 护理

Abstract:

Objective To evaluate the frailty status and risk factors among hospitalized elderly patients after percutaneous coronary intervention（PCI），and to provide a reference for improving and delaying their frailty. Methods From March to August 2024，using convenience sampling，patients aged over 75 years who underwent PCI in a tertiary cardiovascular disease specialist hospital in Beijing were selected as the survey participants. Patient-related informations were collected through a self-designed general information questionnaire. The Fried Phenotype Frailty Scale，the Katz Activities of Daily Living，Lawton Instrumental Activities of Daily Living（IADL） scale，the Charlson Comorbidity Index，the Morse Fall Scale，the Mini Nutritional Assessment-Short Form（MNA-SF），and the 15-item Geriatric Depression Scale（GDS-15） were evaluated postoperatively until discharge. Univariate and multivariate logistic analyses were conducted to identify factors associated with frailty among patients after PCI. Results A total of 278 patients were included. The incidence of frailty after PCI was 52.16%. Based on Fried Phenotype scores，patients were divided into a non-frail group and a frail group. Univariate analysis showed statistically significant differences between the 2 groups in terms of age，gender，hemoglobin，NT-ProBNP，LVEF，IADL scores，living alone status，nutrition status，falls risk，and depression level（P<0.05）. Multivariate logistic regression analysis revealed that age，Lawton IADL scores，falls risk，nutrition status，depression level were factors influencing frailty，with odds ratios of 1.167，0.575，1.597，0.399，and 3.610，respectively（P<0.05）. Conclusion The incidence of frailty is high among patients aged over 75 years after PCI，and there are multiple risk factors affecting their frailty status. Clinical healthcare providers should prioritize long-term management of these patients and implement comprehensive interventions with the consideration of their physiological，psychological，and social conditions.

Key words: Aged, Coronary Heart Disease, Percutaneous Coronary Intervention, Frailty, Root Cause Analysis, Nursing Care

陈阳, 王诗瑜, 高川, 蔡文清, 苏雅静, 张雨萌, 李庆印. 75岁以上经皮冠状动脉介入治疗术后患者衰弱现状及影响因素研究[J]. 中华护理杂志, 2025, 60(13): 1588-1594.

CHEN Yang, WANG Shiyu, GAO Chuan, CAI Wenqing, SU Yajing, ZHANG Yumeng, LI Qingyin. Analysis of the current status and influencing factors of frailty in patients aged 75 and above after percutaneous coronary intervention[J]. Chinese Journal of Nursing, 2025, 60(13): 1588-1594.

图/表 4

表1 研究对象的一般资料及衰弱单因素分析

Table 1 General characteristics and univariate analysis results of the influencing factors of frailty in elderly patients with coronary heart disease after PCI

续表1 研究对象的一般资料及衰弱单因素分析

Table 1(Continued) General characteristics and univariate analysis results of the influencing factors of frailty in elderly patients with coronary heart disease after PCI

表2 自变量赋值

Table 2 Independent variable assignment

表3 75岁以上经皮冠状动脉介入治疗术后患者衰弱多因素Logistic回归分析（n=278）

Table 3 Binary logistic regression analysis of the influencing factors of frailty in patients aged 75 and above after PCI（n=278）

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