肾脏不适当用药对老年糖尿病患者衰弱的影响

杨婉莹; 周湘明; 缪园园; 赵云慧; 王麓; 柯亭羽; 班立丽

doi:10.6039/j.issn.1001-0408.2024.02.16

您当前的位置：

首页 >

文章列表页 >

肾脏不适当用药对老年糖尿病患者衰弱的影响

药物与临床 | 更新时间：2024-01-24

- 肾脏不适当用药对老年糖尿病患者衰弱的影响
- The influence of renally inappropriate medication on the frailty of elderly patients with diabetes
- 中国药房 2024年35卷第2期页码：214-218
- 作者机构：
  
  1.昆明医科大学第二附属医院药学部，昆明　650106
  2.昆明医科大学第二附属医院内分泌科，昆明　650106
- 作者简介：
  
  硕士研究生。研究方向：合理用药。E-mail：2802709437＠qq.com
  副教授，硕士生导师，硕士。研究方向：合理用药。E-mail：1148341017＠qq.com
- 基金信息：
  
  云南省科技厅科技计划项目(202201AY070001-127);云南省“高层次人才培养支持计划”名医专项(YNWR-MY-2020-022)
- DOI：10.6039/j.issn.1001-0408.2024.02.16
  中图分类号： R969.3;R587.1
- 纸质出版日期：2024-01-30，
  
  收稿日期：2023-06-30，
  
  修回日期：2023-12-19，
扫描看全文
杨婉莹,周湘明,缪园园等.肾脏不适当用药对老年糖尿病患者衰弱的影响 ^Δ[J].中国药房,2024,35(02):214-218.

YANG Wanying,ZHOU Xiangming,MIAO Yuanyuan,et al.The influence of renally inappropriate medication on the frailty of elderly patients with diabetes[J].ZHONGGUO YAOFANG,2024,35(02):214-218.
杨婉莹,周湘明,缪园园等.肾脏不适当用药对老年糖尿病患者衰弱的影响 ^Δ[J].中国药房,2024,35(02):214-218. DOI： 10.6039/j.issn.1001-0408.2024.02.16.

YANG Wanying,ZHOU Xiangming,MIAO Yuanyuan,et al.The influence of renally inappropriate medication on the frailty of elderly patients with diabetes[J].ZHONGGUO YAOFANG,2024,35(02):214-218. DOI： 10.6039/j.issn.1001-0408.2024.02.16.

摘要

目的

探讨肾脏不适当用药（RIM）对老年糖尿病患者衰弱的影响。

方法

收集云南省某三级甲等医院2022年1－12月住院的老年糖尿病患者资料，分别采用2019年版Beers标准和汉化版衰弱指数量表（FRAIL量表）对患者的RIM和衰弱情况进行评估，同时根据是否存在RIM将患者分为试验组（存在RIM）和对照组（不存在RIM），并使用倾向性评分匹配法均衡组间混杂因素，通过Logistic回归模型分析RIM对老年糖尿病患者衰弱的影响。

结果

共纳入367例患者，其中80例患者（21.80%）存在RIM，RIM涉及的药物分别是螺内酯（82.56%）、利伐沙班（13.95%）和加巴喷丁（3.49%）。采用倾向性评分匹配法使两组达到组间均衡后，试验组患者的衰弱发生率为77.94%，对照组为27.94%（

＜0.001），而两组间其余混杂因素比较，差异均无统计学意义（

＞0.05）。Logistic回归分析结果显示，试验组患者发生衰弱的风险是对照组的3.118倍（比值比为3.118，95%置信区间为1.758～5.530，

＜0.001）。

结论

RIM是老年糖尿病患者衰弱的危险因素，可考虑将其增补为早期识别和筛查老年糖尿病患者衰弱的一项指标。

Abstract

OBJECTIVE

To investigate the effects of renally inappropriate medication （RIM） on the frailty of elderly patients with diabetes.

METHODS

The data of elderly patients with diabetes mellitus admitted to a third-grade class A hospital in Yunnan province from January to December 2022 were collected， and Beers criteria （2019 edition） and Chinese version of FRAIL scale were used to evaluate RIM and the frailty of the patients； the patients were divided into the trial group （with RIM） and the control group （without RIM） according to whether there was RIM. The propensity score matching was used to balance confounding factors between two groups， and the influence of RIM on the frailty of elderly diabetic patients was analyzed by the Logistic regression model.

RESULTS

Among the 367 patients， 80 patients （21.80%） had RIM， the drugs involved RIM were spironolactone （82.56%）， rivaroxaban （13.95%） and gabapentin （3.49%）. After reaching the balance between groups using the propensity score matching method， the incidence of frailty was 77.94% in trial group and 27.94% in control group （

＜0.001）； the difference was not statistically significant in other confounding factors between the two groups （

＞0.05）. Results of Logistic regression analysis showed that the risk of frailty in the experimental group was 3.118 times that of the control group （odds ratio was 3.118，95% confidence interval was 1.758-5.530，

＜0.001）.

CONCLUSIONS

RIM is a risk factor for the frailty of elderly patients with diabetes， which can be considered as an indicator for early identification and screening of the frailty of elderly diabetes patients.

关键词

肾脏不适当用药衰弱老年糖尿病倾向性评分匹配法

Keywords

frailtyelderlydiabetespropensity score matching

references

CHANG F，O’HARE A M，MIAO Y H，et al. Use of renally inappropriate medications in older veterans：a national study[J]. J Am Geriatr Soc，2015，63（11）：2290-2297.

SINCLAIR A J，ABDELHAFIZ A H，RODRÍGUEZ-MAÑAS L. Frailty and sarcopenia-newly emerging and high impact complications of diabetes[J]. J Diabetes Complications，2017，31（9）：1465-1473.

SHI J，TAO Y K，WANG L X，et al. Combined effect of diabetes and frailty on mortality among Chinese older adults：a follow-up study[J]. Front Endocrinol，2022，13：1105957.

中华医学会老年医学分会，《中华老年医学杂志》编辑委员会. 老年人衰弱预防中国专家共识：2022[J]. 中华老年医学杂志，2022，41（5）：503-511.

Chinese Geriatrics Society，Editorial Board of Chinese Journal of Geriatrics. Chinese expert consensus on prevention of frailty in the elderly：2022[J]. Chin J Geriatr，2022，41（5）：503-511.

The American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers criteria® for potentially inappropriate medication use in older adults[J]. J Am Geriatr Soc，2019，67（4）：674-694.

吴珍珍，张瑞，常艳，等. 衰弱表型和衰弱筛查量表在老年住院患者中的应用比较[J]. 中华护理杂志，2021，56（5）：673-679.

WU Z Z，ZHANG R，CHANG Y，et al. Application comparison of Frailty Phenotype and FRAIL Scale in frailty risk screening of elderly inpatients[J]. Chin J Nurs，2021，56（5）：673-679.

CSCO生物统计学专家委员会RWS方法学组，黄丽红，王永吉，等. 倾向性评分方法及其规范化应用的统计学共识[J]. 中国卫生统计，2020，37（6）：952-958.

RWS Methodology Group of CSCO Biostatistics Expert Committee，HUANG L H，WANG Y J，et al. Statistical consensus on tendency scoring method and its standar-dized application[J]. Chin J Heath Stat，2020，37（6）：952-958.

CAO X Q，LI X Q，ZHANG J Y，et al. Associations between frailty and the increased risk of adverse outcomes among 38 950 UK biobank participants with prediabetes：prospective cohort study[J]. JMIR Public Health Surveill，2023，9：e45502.

ZENG X Z，JIA N，MENG L B，et al. A study on the prevalence and related factors of frailty and pre-frailty in the older population with diabetes in China：a national cross-sectional study[J]. Front Public Health，2022，10：996190.

张培，刘艳. 老年2型糖尿病患者衰弱的发生现状及危险因素分析[J]. 临床医学研究与实践，2022，7（27）：19-23.

ZHANG P，LIU Y. Analysis of the current situation and risk factors of frailty in elderly patients with type 2 dia-betes[J]. Clin Res Pract，2022，7（27）：19-23.

KONG L N，LYU Q，YAO H Y，et al. The prevalence of frailty among community-dwelling older adults with diabetes：a meta-analysis[J]. Int J Nurs Stud，2021，119：103952.

ASSAR M E，LAOSA O，RODRÍGUEZ MAÑAS L. Diabetes and frailty[J]. Curr Opin Clin Nutr Metab Care，2019，22（1）：52-57.

LEE S，LEE S，HARADA K，et al. Relationship between chronic kidney disease with diabetes or hypertension and frailty in community-dwelling Japanese older adults[J]. Geriatr Gerontol Int，2017，17（10）：1527-1533.

WANG Y P，ZHU J，SHAN L C，et al. Potentially inappropriate medication among older patients with diabetic kidney disease[J]. Front Pharmacol，2023，14：1098465.

潘坤明，陈灿，江莹，等. 中国人群药物致急性肾损伤的系统评价[J]. 中国药房，2021，32（9）：1100-1107.

PAN K M，CHEN C，JIANG Y，et al. Systematic review of drug-induced acute kidney injury in Chinese population[J]. China Pharm，2021，32（9）：1100-1107.

中华医学会肾脏病学分会专家组. 糖尿病肾脏疾病临床诊疗中国指南[J]. 中华肾脏病杂志，2021，37（3）：255-304.

Expert Group of Chinese Society of Nephrology. Chinese guidelines for diagnosis and treatment of diabetic kidney disease[J]. Chin J Nephrol，2021，37（3）：255-304.

SHMUEL S，LUND J L，ALVAREZ C，et al. Polypharmacy and incident frailty in a longitudinal community-based cohort study[J]. J Am Geriatr Soc，2019，67（12）：2482-2489.

LIN C L，YU N C，WU H C，et al. Risk factors associated with frailty in older adults with type 2 diabetes：a cross-sectional study[J]. J Clin Nurs，2022，31（7/8）：967-974.

KOBAYASHI S，SUGAMA N，NAGANO H，et al. Renally inappropriate medications in elderly outpatients and inpatients with an impaired renal function[J]. Hosp Pract，2023，51（2）：76-81.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

暂无数据