目的 探讨基于老年综合评估(comprehensive geriatric assessment,CGA)的干预措施对住院高龄(≥80岁)肌少症患者动脉硬化的疗效.方法 选取2022年3～11月武汉市武昌医院老年病科收治的患者292例,根据2019亚洲肌少症工作组(Asian Working Group for Sarcopenia,AWGS)肌少症诊断标准将其分为肌少症组(n=142)与非肌少症组(n=150),比较和分析两组的踝肱指数(ankle-brachial index,ABI)与临床资料;进一步对肌少症组行CGA及干预,观察6个月后,比较肌少症组干预前后ABI、CGA、实验室检查指标及握力、步速的变化情况并进行分析.结果 肌少症组与非肌少症组的年龄、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、ABI、四肢骨骼肌质量指数(appendicular skeletal muscle mass index,ASMI)、握力比较,差异均有统计学意义(P＜0.05);对肌少症组干预6个月后,该组干预前后的LDL-C、TG、TC、尿酸、ABI、日常活动能力评分量表(activities of daily living,ADL)、Morse跌倒风险评估量表(Morse fall assessment scale,MFS)、微型营养评估量表(mini nutritional assessment,MN A)、衰弱筛查量表(the FRAIL scale,Frail)、静息 6m步速的差异均有统计学意义(P＜0.05).结论 基于CGA指导的干预措施在短期内对高龄肌少症患者的动脉硬化程度及生活质量有所改善.
Effect of CGA-based Intervention on ABI in Hospitalised Elderly Patients with Sarcopenia
Objective To investigate the efficacy of CGA-based intervention on atherosclerosis in hospitalised elderly(≥ 80 years)patients with sarcopenia.Methods A total of 292 patients admitted to the Department of Geriatrics,Wuhan Wuchang Hospital from March to November 2022 were selected and divided into sarcopenia group(n=142)and non-sarcopenia group(n=150)according to the diagnostic criteria of 2019 Asian Working Group for Sarcopenia(AWGS),and the ankle-brachial index(ABI)and clinical data of the two groups were compared and analyzed;further CGA and intervention was performed on the sarcopenia group and the changes in ABI,CGA,laboratory test indices and grip strength and step speed results were compared and analyzed in parallel before and after the in-tervention in the sarcopenia group after 6months of observation.Results The differences in age,low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC),ABI,appendicular skeletal muscle mass index(ASMI),and grip strength be-tween the sarcopenia group and the non-sarcopenia group were statistically significant(P＜0.05);after 6months of intervention in the sarcopenia group,the differences in the group's pre-and post-intervention LDL-C,TG,TC,uric acid,ABI,ADL,MFS,MNA,Frail scores,and resting 6m step speeds were statistically significant(P＜0.05).Conclusion CGA-guided interventions improved the degree of arteriosclerosis and quality of life in hospitalised elderly patients with sarcopenia in the short term.
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