血清水平与老年综合征之间的关联范围
Mehmet Ası Oktan1, Cihan Heybeli1, Ozcan Uzun2
1Division of Nephrology, Dokuz Eylul University Hospital, Izmir, Turkey.
目的:
在不同血清钠正常值范围内确定常见老年综合征的患病率。
方法:
在一项横断面研究中,对2016年至2023年间在中国台湾一家老年门诊接受综合老年评估的2048名老年人(年龄≥60岁)进行了分析。患者分组包括中度低钠血症(<130 mEq/L,n=28,1.6%)、轻度低钠血症(130–134 mEq/L,n=130,7.3%)、偏低正常范围(135–140 mEq/L,n=904,50.4%)、偏高正常范围(141–145 mEq/L,n=702,39.2%)以及高钠血症(>145 mEq/L,n=29,1.6%)。另按以下分类进行了单独分析:临界性低钠血症(133–137 mEq/L)、正常(138–142 mEq/L)和临界性高钠血症(143–147 mEq/L)。采用逻辑回归分析评估血清钠分组与老年综合征之间的关联。
结果:
在应用纳入和排除标准后,共纳入1792例患者,平均年龄为81 ± 8岁,其中女性占71%。除老年抑郁症外,所有其他综合征在血钠正常低值范围的发生率均高于正常高值范围。在对年龄、性别、合并症、功能状态及药物暴露进行校正后,血清钠正常高值范围与较低的依赖风险(OR 0.72,95% CI 0.53–0.99,p = 0.043)和较低的营养不良风险(OR 0.69,95% CI 0.51–0.94,p = 0.018)相关。与临界低钠血症相比,临界高钠血症与较低的多重用药风险(OR 0.58,95% CI 0.37–0.89,p = 0.014)、基于日常生活基本活动能力的依赖风险(OR 0.55,95% CI 0.31–0.98,p = 0.042)、营养不良风险(OR 0.55,95% CI 0.33–0.91,p = 0.020)以及衰弱风险(OR 0.65,95% CI 0.44–0.96,p = 0.031)相关。
结论:
与较低的正常钠水平相比,较高的正常钠水平与较低的依赖性和营养不良风险相关。在本单中心研究的老年门诊患者中,与临界低钠血症相比,临界高钠血症与较低的多重用药、依赖性、衰弱和营养不良患病率相关。
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