目的 研究老年住院患者衰弱的相关危险因素，并探究衰弱与脑小血管病的相关性。方法 选取了2020年7月至2022年7月于内蒙古自治区人民医院保健所住院的218例老年患者为研究对象。入院患者行头部MRI检查，行脑小血管病（CSVD）影像学分类，并经专业人员进行衰弱（Fried）、营养等评估。统计老年住院患者衰弱发生情况、相关危险因素及与CSVD各影像类型的关系，并使用logistics回归分析老年住院患者衰弱的危险因素。结果 218例老年住院患者中，衰弱发生率为17.43%（38/218）；一般资料分析显示，女性、年龄、饮酒史、共病≥5种、多重用药≥5种、营养不良为老年住院患者衰弱影响因素，差异有统计学意义（P＜0.05）；相关量表评估结果显示，蒙特利尔认知评估量表(MoCA)、简易精神状态检查(MMSE)、Barthel指数(BI)、简易体能状况量表(SPPB)评分水平降低，起立-行走计时试验(TUGT)、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评分水平上升为老年住院患者衰弱影响因素，差异有统计学意义（P＜0.05）；脑小血管疾病单因素分析中，血管周围间隙扩大（PVS）为老年住院患者衰弱影响因素，差异有统计学意义（P＜0.05）；腔隙性脑梗死（LI）、脑白质高信号（WMH）、微出血（CMB）、血管周围间隙扩大（PVS）和脑萎缩对老年住院患者衰弱发生率无显著影响（P＞0.05）；经Logistic回归分析显示，性别、年龄、共病、多重用药、营养不良、PVS为老年住院患者衰弱独立影响因素（P＜0.05）。结论 高龄、女性、共病、多重用药、营养不良、血管周围间隙扩大的老年住院患者易患衰弱，且高龄、营养不良是衰弱的独立危险因素。

Objective To study the related risk factors of frailty in elderly inpatients and explore the correlation between frailty and cerebral small vessel disease. Methods 218 elderly patients who were hospitalized in the health centre of the Inner Mongolia Autonomous Region People's Hospital from July 2020 to July 2022 were selected as the study subjects. The admitted patients were examined with head MRI, classified with imaging of cerebral small vascular disease (CSVD), and evaluated by professionals for frailty and nutrition. The incidence of senile inpatient frailty, related risk factors and the relationship with CSVD image types were statistically analyzed, and the risk factors of senile inpatient frailty were analyzed by logistic regression. Results Among 218 elderly inpatients, the incidence of frailty was 17.43% (38/218); The analysis of general data showed that women, age, drinking history, comorbidity ≥ 5, multiple drug use ≥ 5, and malnutrition were the influential factors of senile inpatients' frailty, and the difference was statistically significant (P<0.05); The analysis of the evaluation results of the related scales showed that the scores of the Montreal Cognitive Assessment Scale (MoCA), the Simple Mental State Examination (MMSE), the Barthel Index (BI), and the Simple Physical Fitness Scale (SPPB) decreased, and the scores of the Up-and-Walk Timing Test (TUGT), the Hamilton Depression Scale (HAMD), and the Hamilton Anxiety Scale (HAMA) increased to be the factors affecting the frailty of elderly inpatients, with a statistically significant difference (P<0.05); In the univariate analysis of CSVD, the expansion of perivascular space (PVS) was the influential factor of senile inpatients' frailty，and the difference was statistically significant (P<0.05); Lacunar infarction (LI), white matter high signal (WMH), microhemorrhage (CMB), perivascular space expansion (PVS) and brain atrophy had no significant effect on the incidence of senile inpatients' frailty (P>0.05); Logistic regression analysis showed that gender, age, comorbidity, multiple drug use, malnutrition, and PVS were independent influencing factors of senile inpatients' frailty (P<0.05). Conclusion Elderly hospitalized patients with advanced age, female, comorbidity, multiple drug use, malnutrition, and enlarged perivascular space are prone to frailty, and advanced age and malnutrition are independent risk factors for frailty.

院内课题 2020YN25