| 杨启瑞,白婷婷,蒋倩雯,张伟奇,赵伟,吴方,李菲卡.基于多学科协作评估的老年射血分数保留的心力衰竭合并肌少症与内在能力受损分析[J].老年医学与保健,2026,32(3):360-366 |
| 基于多学科协作评估的老年射血分数保留的心力衰竭合并肌少症与内在能力受损分析 |
| Analysis of sarcopenia and intrinsic capacity impairment in elderly HFpEF patients based on multi-disciplinary team assessment |
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| DOI：10.3969/j.issn.1008-8296.2026.03.008 |
| 中文关键词: 多学科诊疗 射血分数保留的心力衰竭 肌少症 内在能力 |
| 英文关键词: multidisciplinary team heart failure with preserved ejection fraction sarcopenia intrinsic capacity |
| 基金项目:Z-2017-24-2403:中华医学会肠外肠内营养学分会医学营养专项研究基金 |
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| 中文摘要: |
| 目的 探讨肌少症与老年射血分数保留的心力衰竭(HFpEF)患者内在能力受损程度之间的关联.方法 回顾性收集2018 年1 月至2020 年6 月于上海交通大学医学院附属瑞金医院及其协作社区医院、护理院住院治疗的356 例老年 HFpEF 患者资料.基于多学科诊疗模式,对患者内在能力的5 个维度进行全面评估.采用有序 Logistic 回归模型分析肌少症与内在能力受损的相关性,并通过剔除运动功能维度后重建内在能力评分进行敏感性分析.结果 共纳入356 例患者,其中151 例(42.4%)合并肌少症.多因素有序 Logistic 回归分析显示,肌少症与内在能力受损加重呈独立相关(OR=1.932,95%CI:1.157～3.263,P=0.012).敏感性分析表明,剔除运动功能维度后,两者关联强度减弱且不再具有统计学意义(OR=1.208,95%CI:0.694～2.119,P=0.506).结论 肌少症与老年 HFpEF 患者内在能力受损显著独立相关,其影响可能主要通过运动功能维度介导.临床上应重视对肌少症的早期筛查与综合评估,但其对内在能力的作用机制及靶向干预效果仍有待前瞻性研究进一步验证. |
| 英文摘要: |
| Objective To explore the correlation between sarcopenia and the degree of intrinsic capacity impairment in elderly patients with heart failure with preserved ejection fraction(HFpEF).Methods Data from 356 elderly HFpEF patients admitted to Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,as well as its collaborating community hospitals and nursing homes from January 2018 to June 2020 were retrospectively collected.Based on a multidisciplinary team assessment model,a comprehensive assessment of the five dimensions of the intrinsic capacity of the patients was conducted.Ordered Logistic regression analysis was used to analyze the correlation between sarcopenia and intrinsic capacity impairment.A sensitivity analysis was performed by reconstructing the intrinsic capacity score after excluding the locomotion dimension.Results Among the 356 patients,151(42.4%)were diagnosed with sarcopenia.The multivariate ordered Logistic regression analysis showed that sarcopenia was independently associated with a significant aggravation of intrinsic functional impairment(OR=1.932,95%CI:1.157-3.263,P=0.012).The sensitivity analysis indicated that,after excluding the locomotion dimension,the correlation strength between the two variables weakened and no longer had statistical significance(OR=1.208,95%CI:0.694-2.119,P=0.506).Conclusion Sarcopenia is significantly and independently associated with intrinsic capacity impairment in elderly HFpEF patients,and this effect may be primarily mediated through the locomotion dimension.Early screening and comprehensive assessment of sarcopenia should be emphasized in clinical practice.However,the underlying mechanisms and the effectiveness of targeted interventions on intrinsic capacity still require further validation through prospective studies. |
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