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．

目的 总结以双下肢乏力为主要表现的、合并低叶酸血症的患者的临床特征。方法 选择自2017年1月—2020年12月在我院神经内科住院的患者,分为3组：双下肢乏力伴叶酸缺乏组,共23例;叶酸缺乏合并脑血管病组,共129例;叶酸缺乏的健康体检者,为来我院行健康体检、无意中发现叶酸水平降低者,共42例,比较3组患者特征。结果 双下肢乏力伴叶酸缺乏组患者的发病年龄在19~88岁之间,平均（63.82±20.24）岁,男女比为2.3∶1。起病时间（13.34±17.88）d。与叶酸缺乏合并脑血管病组以及与叶酸缺乏的健康体检者相比,双下肢乏力伴叶酸缺乏组患者脑叶缺血灶数量较少,差异有统计学意义,P分别=0.001和0.008;与叶酸缺乏的健康体检者相比,双下肢乏力伴叶酸缺乏组患者放射冠和侧脑室缺血灶数量无变化,差异无统计学意义,P>0.05;与叶酸缺乏合并脑血管病组以及与叶酸缺乏的健康体检者相比,双下肢乏力伴叶酸缺乏组患者整体脑组织缺血灶总数较少,差异有统计学意义,P分别<0.01和0.05。结论 临床上遇到双下肢乏力患者,尤其是发病年龄在63岁左右,男性,起病时间在13 d左右,颅内整体缺血灶、尤其脑叶缺血灶较少的患者,需要警惕低叶酸血症所致双下肢乏力的可能。

Objective To summarize the clinical characteristics of patients with lower extremity weakness as the main manifestation and hypofolicemia．Methods Patients admitted in our neurology inpatient center from January 2017 to December 2020 were selected and divided into 3 groups．Group A consisted of 23 cases of bilateral lower extremity weakness combined with folic acid deficiency．Group B consisted of 129 cases of folic acid deficiency combined with cerebrovascular disease．Group C consisted of 42 healthy people with folic acid deficiency who came to our hospital for health check-up and found that the level of folic acid was decreased accidentally．The clinical characteristics of the three groups of patients were compared．Results The age of onset in group A was between 19 and 88 years old,with an average of（63.82±20.24）years old,and the male to female ratio was 2.3∶1．The onset time was（13.34±17.88）days．Compared with the group B and group C,the number of cerebral lobe ischemic area in group A was lesser,and the difference was statistically significant,P=0.001 and 0.008,respectively．Compared with group C,the number of corona radiata and lateral ventricle ischemic lesions in group A did not change,and the difference was not statistically significant,P>0.05．Compared with group B and group C,the total number of ischemic lesions in the overall brain tissue of group A was lesser,and the difference was statistically significant,P<0.01 and P=0.05 respectively．Conclusions When we encounter patients with bilateral lower extremity weakness in clinical practice,especially the average age of onset is around 63 years old,male,the onset time is about 13 days,and the overall intracranial ischemic lesions,especially the lobar ischemic lesions are less,we need to think of the possibility of bilateral lower extremity weakness caused by hypofolate．