论著

住院老年患者PICC相关性血栓的影响因素分析

Analysis of influencing factors for PICC-related thrombosis in hospitalized elderly patients

:433-445
 
      目的 调查住院老年患者因经外周静脉置入中心静脉导管(PICC)而引发的血栓情况,并分析其影响因素,为老年患者置入PICC产生的相关性血栓(PICC-CRT)和症状性血栓的评估与干预提供借鉴。方法 在2023年1月—2023年12月期间,选取广州市第一人民医院接受PICC置管的317例住院老年患者。采用包括患者一般情况调查表、运动功能评定、肌力检测、 Barthel指数评定、Padua评分等多种工具进行综合评估。采用多因素 Logistic 回归构建 PICC-CRT 及症状性血栓的预测模型,并应用逐步回归法优化变量筛选过程。模型性能通过 ROC 曲线进行评估。结果 去除临床资料不完整的患者40例,最终纳入277例患者的完整资料,其中123例患者出现了PICC-CRT,发生率为44.40%(123/277)。血栓分级中,I级78例,Ⅱ级37例,Ⅲ级8例。无症状血栓83例,占67.48%,发生率29.96%(83/277);症状性血栓40例,占32.52 %,发生率14.44%(40/277)。单因素分析联合多因素Logistic回归显示,卒中史、凝血酶原时间(PT)、导管留置时间是住院老年患者PICC-CRT的关键因素(P<0.05),预测模型ROC曲线下面积为0.719;置管史、恶性肿瘤史、导管留置时间、置管后并发症数量是住院老年患者PICC症状性血栓的独立影响因素(P<0.05),预测模型ROC曲线下面积为0.812。结论 文章总结了PICC-CRT和症状性血栓独特的影响因素,基于关键因素构建了预测模型预测其发生,为护理人员预防PICC-CRT和症状性血栓的发生提供了参考。

   Objective To explore the incidence of thrombosis associated with peripherally inserted central catheter(PICC)placement in hospitalized elderly patients and to analyze its influencing factors,in order to provide a reference for the assessment and prevention of PICC-catheter related thrombosis(PICC-CRT)and symptomatic thrombosis in this population.Methods A total of 317 elderly inpatients who underwent PICC placement at a tertiary hospital in Guangzhou between January and December 2023 were enrolled.Comprehensive assessments were conducted using general patient information forms,motor function evaluation,muscle strength testing,Barthel Index,and Padua score.Multivariate Logistic regression analysis was used to construct predictive models for PICC-CRT and symptomatic thrombosis,with variable selection optimized via stepwise regression.Model performance was evaluated using receiver operating characteristic(ROC)curve analysis.Results After excluding 40 patients with incomplete clinical data,277 cases were included in the final analysis.Among them,123 patients developed PICC-CRT,with an incidence rate of 44.40%(123/277).Thrombosis was graded as Grade I in 78 cases,Grade II in 37 cases,and Grade III in 8 cases.Asymptomatic thrombosis occurred in 83 cases(29.96%),accounting for 67.48% of PICC-CRT;symptomatic thrombosis occurred in 40 cases(14.44%),accounting for 32.52%.Univariate and multivariate Logistic regression analyses identified history of stroke,prothrombin time(PT),and catheter dwell time as key risk factors for PICC-CRT(P<0.05),with the area under the curve(AUC)of 0.719.History of catheterization,malignancy,catheter dwell time,and number of post-catheterization complications were independent predictors of symptomatic thrombosis(P<0.05),with an AUC of 0.812.Conclusions This study identified distinct risk factors for PICC-CRT and symptomatic thrombosis in elderly inpatients.Predictive models based on key variables may provide useful references for clinical staff in preventing the occurrence of PICC-related and symptomatic thrombosis.

运动干预对老年肌少性肥胖患者疗效的Meta分析

Effects of exercise intervention in elderly patients with Sarcopenia Obesity: a meta-analysis

:-
 
目的 评价不同运动干预对老年肌少性肥胖患者健康状况的干预效果。 方法 计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方数据库、维普数据库中关于运动干预老年肌少性肥胖患者的运动干预的随机对照试验,检索时限为建库至2025年8月。采用RevMan 5.4软件进行统计分析。 结果 共计纳入13篇文献,815名参与者。运动可显著改善患者身体质量指数 (P<0.0001)、体脂率 (P=0.001)、四肢骨骼肌质量(P<0.0001)、握力(P=0.007)、步速 (P=0.0003)、起立-行走计时测试用时(P<0.00001),提高患者IGF-1水平(P =0.0003);但IL-6(P =0.96)、血清总胆固醇(P=0.22)未见明显改变。 结论 运动可以有效降低肌少性肥胖患者的身体质量指数、体脂肪, 提高肌少性肥胖患者的身体机能、四肢骨骼肌质量和IGF-1水平,其中多组分运动和抗阻运动效果更加显著。
Objective To evaluate the effect of different exercise intervention on the health status of elderly patients with sarcopenia and obesity. Methods PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang database and VIP database were searched for randomized controlled trials on exercise intervention in elderly patients with sarcopenia and obesity until August 2025.Two researchers independently screened the literature, extracted the data, and evaluated the bias risk of the included studies, and then used RevMan 5. 3 software for statistical analysis. Results a total of 13 articles involving 815 participants were included.Exercise significantly reduced body mass index (P < 0.0001), body fat percentage (P = 0.001), and increased limb skeletal muscle mass (P < 0.0001).Exercise significantly improved the patient's grip strength (P = 0.007), pace (P = 0.0003), and decreased the time spent on the timed up-and-go test (P < 0. 00001).Exercise significantly increased serum IGF-1 levels (P = 0.0003), but did not significantly change serum IL-6 (P = 0.96) and serum total cholesterol (P = 0.22). Conclusion Exercise can effectively reduce the body mass index and body fat, and improve the body function, limb skeletal muscle mass and IGF-1 level in patients with sarcopenia obesity, and the effects of multi-component exercise and resistance exercise are more significant.
论著

多组分运动训练对老年 COPD 稳定期病人骨骼肌功能的影响

The effect of multi-component exercise training on skeletal muscle function in elderly patients with stable COPD

:345-351
 
       目的  探讨多组分运动训练对老年慢性阻塞性肺疾病(COPD)稳定期病人骨骼肌功能的影响。方法 瞻性选择2022年10月—2024年10月90例COPD稳定期患者,采用抽签法随机分为观察组与对照组,对照组45例采取常规运动干预,观察组45例在对照组基础上增加多组分运动训练。干预前、干预后3个月比较两组患者四肢骨骼肌含量,四肢肌群力量,运动耐力与肺功能,生活质量。结果 干预后,两组上肢、下肢骨骼肌含量均略增加,观察组高于对照组(P<0.05);干预后,两组膝伸肌、膝屈肌、肘伸肌、肘屈肌肌群力量均增加,观察组高于对照组(P<0.05);干预后,两组6 min步行试验、用力肺活量及第一秒用力呼气量均升高,观察组高于对照组(P<0.05);干预后,两组圣乔治呼吸问卷各维度分数及总分均降低,观察组低于对照组(P<0.05)。结论  针对老年COPD稳定期患者采取多组分运动训练可提升患者四肢骨骼肌含量与四肢肌群力量,改善患者运动耐力与肺功能,减轻COPD及骨骼肌功能障碍对患者生活质量造成的负面影响。
        Objective  To explore the effect of multi-component exercise training on skeletal muscle function in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods  From October 2022 to October 2024,90 stable COPD patients were prospectively selected and randomly divided into an observation group and a control group using a lottery method.The control group consisted of 45 patients who received routine exercise care,while the observation group  consisted of 45 patients who received multi-component exercise training in addition to the routine care.Skeletal muscle content,muscle group strength,exercise endurance,lung function,and quality of life between two groups of patients were compared before and three months after intervention.Results  After intervention,the skeletal muscle content of both upper and lower extremities slightly increased in both groups,with the observation group  being higher than the control group(P<0.05).After intervention,the strength of the knee extensor,knee flexor,elbow extensor,and elbow flexor muscle groups increased in both groups,with the observation group  had better results than the control group(P<0.05).After intervention,both groups showed an increase in six-minute walking test,forced vital capacity,and forced expiratory volume in first second,with the observation group  had better  results than the control group(P<0.05).After intervention,the scores of each dimension and total score of the SGRQ in both groups decreased,and the observation group had lower scores than the control group(P<0.05).Conclusions  Multi-component exercise training for stable elderly COPD patients can improve the skeletal muscle content and muscle strength of the extremities,enhance exercise endurance and lung function,and alleviate the negative impact of COPD and skeletal muscle dysfunction on patients’quality of life.
论著

基于决策树的住院老年患者吞咽障碍风险预测模型的研究

Research on decision tree based risk prediction model for dysphagia in elderly inpatients

:308-314
 
      目的   基于决策树构建老年患者吞咽障碍预警模型。方法  采用便利取样法对宁夏银川市宁夏回族自治区人民医院老年科住院的200例老年患者进行调查。结果  200例老年患者中,吞咽障碍发生率为40.5%。依据是否发生吞咽障碍将其患者分为两组,两组患者在性别、年龄、文化程度、职业、医保类型、家庭年收入、日常生活能力、衰弱、抑郁、营养、体质指数(BMI)比较(χ 2 值分别为13.321、4.064、31.944、36.695、18.230、19.681、52.509、10.253、20.456、9.070、9.483),差异均有统计学意义(均P<0.05)。决策树模型筛选出老年患者吞咽障碍的影响因素主要有自理能力、职业、文化程度和抑郁,决策树模型受试者工作特征曲线下面积为0.862,灵敏度为79.8%,特异度为79.0%,P<0.001。结论  基于自理能力、职业、文化程度和抑郁构建的决策树模型,能有效预测老年患者吞咽障碍风险。
       Objective  To construct a swallowing disorder warning model for elderly patients based on decision tree.Methods  Convenience  sampling was  used to  study  200  elderly  patients  admitted to the  geriatric  department  of  a tertiary comprehensive hospital in Yinchuan,Ningxia.Results  Among 200 elderly patients,the incidence of swallowing disorders was 40.5%.The two groups of patients were compared in terms of gender,age,education level,occupation,medical insurance type,annual family income,daily living ability,frailty,depression,nutrition,and BMI(χ 2  values were 13.321,4.064,31.944,36.695,18.230,19.681,52.509,10.253,20.456,9.070,9.483,respectively),and the  differences were  statistically significant(all P<0.05).The decision tree model identified the main influencing factors of swallowing disorders in elderly patients as self-care ability,occupation,education level,and depression.The Receiver Operating Characteristic curve of the decision tree model had an area under the curve of 0.862,sensitivity of 79.8%,and specificity of 79.0%,P<0.001.Conclusions  A decision tree model based on self-care ability,occupation,education level,and depression can effectively predict the  risk of swallowing disorders in elderly patients.
论著

多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭并发衰弱患者的效果

The effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure and frailty

:202-208
 
       目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭(CHF)并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低(P<0.05)。与对照组相比,观察组干预后左室射血分数(LVEF)水平明显更高,超敏心肌肌钙蛋白T(hs-cTnT)、N末端B型利钠肽前体(NT-proBNP)、左室舒张末期内径(LVEDD)水平更低(P<0.05)。与对照组相比, 观察组干预后主观整体营养状况评价表(PG-SGA)评分明显更低,血红蛋白(Hb)、前白蛋白(PA)、白蛋白(ALB)水平更高(P<0.05)。与对照组相比,观察组干预后症状、身体、情感及总分更低(P<0.05)。观察组不良事件发生率(1.96%)低于对照组(15.69%)(P<0.05)。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。
       Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure(CHF)and frailty.Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included. According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention.The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups.Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention(P<0.05).Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention(P<0.05).Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention(P<0.05).Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention(P<0.05).The incidence of adverse events in the observation group(1.96%)was lower than that in the control group(15.69%)(P<0.05).Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events.
论著

老年脆性骨折患者术前衰弱前期、衰弱现状调查及影响因素分析

Status of preoperative weakness and influencing factors in elderly patients with osteoporotic fracture

:188-194
 
       目的 调查老年脆性骨折患者术前衰弱现况,并分析影响因素。方法 采用便利抽样法, 2024年11月—2025年3月, 选取于广州市某三甲医院骨科住院的207例老年脆性骨折患者, 使用一般资料调查表、简易衰弱评估量表、简版流调中心抑郁量表、广泛性焦虑量表和营养风险筛查量表2002开展问卷调查。采用有序分类Logistic回归, 分析老年脆性骨折患者术前衰弱的影响因素。结果 207例老年脆性骨折患者的术前衰弱前期占48.3%, 衰弱发生率为23.2%。有序分类Logistic 回归分析结果显示年龄(OR=1.131)、睡眠差(OR=2.557)、合并3种及以上慢性病(OR=3.990)、抑郁(OR=3.296)、营养不良风险(OR=4.005)为老年脆性骨折患者术前衰弱的危险因素,BMI正常(OR=0.206)是保护因素(均P<0.05)。结论 老年脆性骨折患者年龄, 睡眠情况, 多种共病,抑郁, 存在营养不良风险及BMI影响其术前衰弱水平, 重视衰弱的筛查及早期干预, 提升患者治疗效果和生活质量。
       Objective To explore the preoperative frailty status and influencing factors in elderly patients with osteoporotic fractures.Methods Using convenience sampling, 207 elderly patients with osteoporotic fractures admitted to the orthopedic department of a tertiary hospital in Guangzhou from November 2024 to March 2025 were selected.Data were collected using a general information questionnaire, the Frail Scale, the 10-item Center for Epidemiologic Studies Depression Scale(CES-D-10), the Generalized Anxiety Disorder Scale(GAD-7), and the Nutritional Risk Screening 2002(NRS-2002).Logistic regression was used to analyze factors influencing preoperative frailty.Results Among 207 elderly patients with osteoporotic fractures, the incidence of early stages of frailty was 48.3%, and the incidence of frailty was 23.2%.Logistic regression analysis revealed the following risk factors for preoperative frailty:age(OR=1.131), poor sleep quality(OR=2.557), multiple chronic comorbidities(OR=3.990), depression(OR=3.296), nutritional risk(OR=4.005).Normal body mass index(OR=0.206)was a protective factor.Conclusions Advanced age,poor sleep quality, multiple chronic comorbidities, depression, nutritional risk and body mass index are associated with frailty in elderly osteoporotic fracture patients.Health care providers should pay attention to frailty screening and early intervention, which can reverse or delay the progression of frailty and improve the treatment effect and quality of life of patients.
论著

非酒精性脂肪肝老年人体质辨识及中医治未病服务对其治疗效果探讨

Identification of the constitution of the elderly with nonalcoholic fatty liver disease and discussion on the therapeutic effect of preventing disease before arising

:63-69
 
       目的   研究非酒精性脂肪肝老年人体质辨识及中医治未病服务对其治疗效果。方法   选择2023年1月—2024年1月贵州中医药大学第一附属医院就诊的非酒精性脂肪性肝病老年患者70例作为研究对象,根据患者就诊顺序分配为两组。对照组35例,接受常规干预;观察组35例,其在对照组基础上予中医“治未病”理念下体质辨识干预模式。比较两组干预效果,以及干预前后血脂水平、肝功能、生存质量的变化。结果   观察组的治疗总有效率91.43%,高于对照组的68.57%,差异有统计学意义(P<0.05)。治疗前,两组各项血脂水平、肝功能、慢性肝病问卷(CLDQ)评分比较,差异无统计学意义(P>0.05);治疗后,两组各项血脂水平优于治疗前,各项肝功能低于治疗前,CLDQ评分高于治疗前,差异有统计学意义(P<0.05);治疗后,观察组的各项血脂水平优于对照组,各项肝功能低于对照组,CLDQ评分高于对照组,差异有统计学意义(P<0.05)。结论   对非酒精性脂肪性肝病老年患者而言,中医“治未病”理念下体质辨识干预服务能够提高其治疗效果,调节血脂水平的异常,改善肝功能及生存质量,值得应用。
       Objective  To study the physical identification of nonalcoholic fatty liver in the elderly and the therapeutic effect of traditional Chinese medicine on preventing disease before arising.Methods  A total of 70 elderly patients with nonalcoholic fatty liver disease treated in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2023 to January 2024 were selected as the study objects.Patients were assigned to two groups,control group(35 cases)received  routine intervention,observation group(35 cases)received physical identification intervention based on preventing disease before arising of traditional Chinese medicine additionally.The effect of intervention and the changes of blood lipid levels,liver function and quality of life before and after intervention were compared between the two groups.Results  The total effective rate of the observation group was 91.43%,higher than that of the control group(68.57%),the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in blood lipid levels,liver function and CLDQ scores between the two groups(P>0.05).After treatment,the levels of blood lipids were better than those before treatment,liver function was lower than that before treatment,CLDQ score was higher than that before treatment,the difference was statistically significant(P<0.05).After treatment,the blood lipid levels of the observation group was better than that of the control group,the liver function was lower than that of the control group,and the CLDQ score was higher than that of the control group,with statistical significance(P<0.05).Conclusions  For elderly patients with nonalcoholic fatty liver disease,the intervention service of body constitution identification under the concept of preventing disease before arising of traditional Chinese medicine can improve the therapeutic effect,regulate the abnormal blood lipid levels,improve liver function and quality of life,which is worthy of application.
论著

广州市某三甲医院老年住院患者服务需求现状及影响因素分析

Current status and influencing factors of elderly patients’ service needs in Guangzhou

:1736-1744
 
       目的   调查老年人照护服务需求现状并分析其影响因素,为构建基于需求为导向的老年照护服务体系提供参考依据。方法  采用便利抽样法,选取广州市某三甲医院212名老年人作为调查对象,采用日常生活能力量表、Fried衰弱评估量表及自行编制的老年人需求评估问卷进行调查。结果   老年人对运动与营养(1.96±0.90分)、心理慰藉(2.63±0.85分)、安宁服务(2.73±1.07分)的需求水平较高。多因素线性回归分析结果显示养老方式、日常生活活动能力、爱好数量、性别、衰弱等级、有无主要照顾者是照护服务需求的影响因素(P均<0.05),可解释61.5%的变异量。   老年人的照护服务需求受多种因素的影响。应根据老年人的不同特征,构建供需匹配的多元化,多层次照护体系。
       Objective  To investigate the status quo of care service needs of the elderly and analyze its influencing factors,so as to provide a reference for the construction of a needs-oriented care service system for the elderly.Methods  A total of 212 elderly people from a tertiary hospital in Guangzhou were selected by convenience sampling method and investigated with the Activity of Daily Living scale,Fried frailty scale and the self-designed elderly needs assessment questionnaire.Results  Elderly patients had higher demands for exercise,nutrition,psychological comfort and hospice services.The results of multivariate analysis showed that the influencing factors of care service demand included pension style,activities of daily living,number of hobbies,gender,frailty level,and having main caregivers(all P<0.05),which could explain 61.5% of the variation.Conclusions  The care needs of elderly patients are affected by many factors.A diversified and multi-level care system with matching supply and demand should be constructed according to the different characteristics of the elderly.
论著

老年脑梗死患者抑郁与共病的相关性分析

The correlation between depression and comorbidity in elderly patients with cerebral infarction

:940-944
 
目的 探究老年脑梗死患者抑郁与共病之间的相关性。方法 选择2021年9月—2023年7月于开封市第五人民医院接受治疗的80例老年脑梗死康复期患者,均使用老年抑郁量表(GDS)对其进行评测,按照评测结果将患者区分为无抑郁组(n=39,GDS≤10分)和抑郁组(n=41,GDS>10分),并按照受试者是否存在共病区分为不同亚组(如并消化系统疾患、并发循环系统疾患等),对比不同亚组患者占比差异,并采用Pearson相关性分析的方式,分析入组80例老年脑梗死患者GDS评分与其Charlson共病指数(CCI)评分的相关性。结果 80例患者中抑郁占比为51.25%,对比显示共病循环系统、内分泌系统以及运动系统疾病的老年脑梗死患者抑郁发生率明显更高(P<0.05);Pearson相关性分析显示老年脑梗死患者GDS评分与其CCI评分呈正相关(r=0.180,P<0.001)。结论 老年脑梗死患者抑郁发生率较高,对并发循环系统疾病、内分泌系统疾病、运动系统疾病的老年脑梗死患者应予以更多关注,预防抑郁的发生。
Objective To explore the correlation between depression and comorbidity in elderly patients with cerebral infarction.Methods A total of 80 elderly patients treated from September 2021 to July 2023 were selected.The patients were evaluated using the Geriatric Depression Scale(GDS),patients were divided into the non-depression group(n=39,GDS≤10 points)and the depression group(n=41,GDS>10 points),and they were divided into different subgroups(such as concurrent digestive disorders,concurrent circulatory disorders,etc.).Comparing the differences in patient proportions in different subgroups,and the correlation between the GDS score and its Charlson comorbidity index(CCI)score in 80 elderly patients with cerebral infarction was analyzed with Pearson correlation analysis.Results The proportion of depression in 80 patients was 51.25%,showing a significantly higher incidence of depression in elderly patients with a comorbid circulatory system,endocrine system and motor system disease(P<0.05);Pearson correlation analysis showed that GDS score in elderly patients with a cerebral infarction was positively correlated with their CCI score(r=0.180,P<0.001).Conclusions The incidence of depression in elderly patients with cerebral infarction is relatively high,and more attention should be paid to elderly patients with concurrent circulatory system diseases,endocrine system diseases and motor system diseases to prevent the occurrence of depression.
论著

老年慢性心力衰竭患者血清SCD-1和sVEGFR-2表达水平及其与预后的评估价值研究

Expression levels of serum SCD-1 and sVEGFR-2 in elderly patients with chronic heart failure and their prognostic value

:241-246
 
目的 探究血清多配体蛋白聚糖-1(SCD-1)与可溶性血管内皮生长因子受体-2(sVEGFR-2)表达水平在老年慢性心力衰竭患者预后评估的判定价值。方法 选取2023年1月—2024年3月珠海市第五人民医院检验科收治的110例老年慢性心力衰竭患者,检测其血清SCD-1和sVEGFR-2水平,对患者进行随访调查,了解其再次由于心力衰竭住院、心源性死亡的情况。运用多因素Logistic回归分析,探究老年慢性心力衰竭患者预后影响因素。结果 Logistic回归分析显示,心功能分级(OR=3.433,95%CI:0.934~6.431)、B型脑钠肽升高(OR=2.462,95%CI:0.861~4.765)、血清SCD-1升高(OR=3.795,95%CI:0.972~6.894)、血清sVEGFR-2升高(OR=3.842,95%CI:0.942~6.912)为影响老年慢性心力衰竭患者预后不良的重要因素(P<0.05);联合血清SCD-1和sVEGFR-2曲线下面积0.962与B型脑肽钠曲线下面积0.844,相较于单一SCD-1曲线下面积0.658、sVEGFR-2曲线下面积0.712明显偏高(P<0.05)。结论 经研究证实,老年慢性心力衰竭患者预后效果不理想,其血清SCD-1和sVEGFR-2监测水平异常升高,和老年慢性心力衰竭预后不佳存在关联性,可视为老年慢性心力衰竭患者判定预后效果的主要标志物。
Objective To investigate the prognostic value of serum syndecan-1(SCD-1)and soluble vascular endothelial growth factor receptor-2(sVEGFR-2)expression levels in elderly patients with chronic heart failure. Methods A total of 110 elderly patients with chronic heart failure admitted to our hospital were selected,with a time interval of January 2023 to March 2024.Serum SCD-1 and sVEGFR-2 levels were detected and follow-up investigations were conducted to understand their re hospitalization and cardiogenic death due to heart failure.Multiple logistic regression analysis was used to explore the prognostic factors affecting elderly patients with chronic heart failure. Results According to logistic retrospective analysis,heart function grading(OR=3.433,95%CI:0.934-6.431),elevated B-type brain natriuretic peptide(OR=2.462,95%CI:0.861-4.765),elevated serum SCD-1(OR=3.795,95%CI:0.972-6.894),and elevated serum sVEGFR-2(OR=3.842,95%CI:0.942-6.912)were important factors affecting the poor prognosis of elderly patients with chronic heart failure,with differences P<0.05.The area under the curve of combined serum SCD-1 and sVEGFR-2 was 0.962,and the area under the curve of B-type brain peptide sodium was 0.844,which was significantly higher than that of a single SCD-1 curve of 0.658 and sVEGFR-2 curve of 0.712,with a difference of P<0.05. Conclusions Research has confirmed that the prognosis of elderly patients with chronic heart failure is not satisfied,and their serum SCD-1 and sVEGFR-2 monitoring levels are abnormally elevated,which is related to the poor prognosis of elderly patients with chronic heart failure.It can be regarded as the main biomarker for defining the prognosis of elderly patients with chronic heart failure.
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