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HRR、Cr/Cys-C在高血压合并冠心病的老年患者衰弱的研究进展
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Abstract:
衰弱是指机体多种系统功能异常或生理储备下降，导致易感性、易损性增加，抗应激能力减退的一种非特异性状态，致使衰弱老年人更易发生跌倒、残疾、感染甚至死亡等不良健康结局。在我国，心血管疾病是老年人常见的一类疾病，包括心脏和血管疾病，是引起死亡的主要疾病。由于高血压合并冠心病的老年患者衰弱的发生率高，预后差，故临床医师在接诊这部分特殊人群时，可对其进行衰弱评估表的初步筛查，有助于识别衰弱，从而制定更合理的诊疗计划，有助于改善老年人的健康状况。冠心病合并高血压的老年患者和衰弱的病理生理机制与炎性反应、氧化应激反应及激素代谢紊乱等因素相关。衰弱通常影响多个生理系统，冠心病合并高血压的老年衰弱患者更容易出现与此相关的不良预后(如跌倒、骨折、骨骼肌减少、残疾、认知障碍)，这导致了更高的住院率。目前国内外对冠心病合并高血压衰弱的研究逐渐重视。寻找合适的生物标志物对冠心病合并高血压衰弱进行早期诊断、病情监测和预后判断具有重要意义，本文旨在对HRR、Cr/Cys-C与高血压合并冠心病老年患者衰弱的研究进行综述。
Frailty refers to a non-specific state in which the function of various systems of the body is abnormal or the physiological reserve is decreased, leading to the increase of susceptibility and vulnerability and the decrease of anti-stress ability, which makes the frailty elderly more prone to fall, disability, infection and even death and other adverse health outcomes. Cardiovascular disease is a common disease in the elderly in China, including heart and blood vessel disease, which is the main cause of death. Due to the high incidence of frailty in elderly patients with hypertension combined with coronary heart disease and poor prognosis, clinicians can conduct preliminary screening of frailty assessment form when receiving this part of the special population, which helps to identify frailty, so as to formulate a more reasonable diagnosis and treatment plan, and help to improve the health status of the elderly. The pathophysiological mechanism of frailty in elderly patients with coronary heart disease complicated with hypertension is related to inflammatory response, oxidative stress response and hormone metabolism disorder. Frailty often affects multiple physiological systems, and elderly frailty patients with coronary heart disease combined with hypertension are more likely to have associated poor outcomes (such as falls, fractures, sarcopenia, disability, cognitive impairment), which leads to higher rates of hospitalization. At present, more and more attention has been paid to the research of coronary heart disease combined with hypertension frailty. Finding suitable biomarkers is of great significance for early diagnosis, disease monitoring and prognosis judgment of coronary heart disease complicated with hypertension frailty. This paper aims to review the research on HRR, Cr/Cys-C and hypertension combined with coronary heart disease in elderly patients with frailty.
| [1] | 张勇, 刘晖. 人口新形势对高职教育未来发展的制约与对策——基于第七次全国人口普查的分析[J]. 教育与职业, 2022(6): 12-20. |
| [2] | 樊凡, 杨翠, 王庆松. 衰弱与老年心脑血管疾病关系的研究进展[J]. 中华老年心脑血管病杂志, 2019, 21(2): 207-210. |
| [3] | 袁弯, 张玉莲, 张慧瑛. 2020版ICFSR老年衰弱指南解读[J]. 中华现代护理杂志, 2021, 27(35): 4770-4773. |
| [4] | Fried, L.P., Tangen, C.M., Walston, J., et al. (2001) Frailty in Older Adults: Evidence for a Phenotype. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 56, M146-M156. https://doi.org/10.1093/gerona/56.3.M146 |
| [5] | Metze, C., Matzik, A.-S., Scherner, M., et al. (2017) Impact of Frailty on Outcomes in Patients Undergoing Percutaneous Mitral Valve Repair. JACC: Cardiovascular Interventions, 10, 1920-1929. https://doi.org/10.1016/j.jcin.2017.07.042 |
| [6] | WHO (2020) China Country Assessment Report on Ageing and Health. World Health Organization, Geneva. |
| [7] | Hoogendijk, E.O., Afilalo, J., Ensrud, K.E., et al. (2019) Frailty: Implications for Clinical Practice and Public Health. The Lancet, 394, 1365-1375. https://doi.org/10.1016/S0140-6736(19)31786-6 |
| [8] | Morley, J.E., Malmstrom, T.K. and Miller, D.K. (2012) A Simple Vulnerability Questionnaire (FRAIL) Predicts Outcomes for Middle-Aged African Americans. Journal of Nutrition, Health, and Aging, 16, 601-608. https://doi.org/10.1007/s12603-012-0084-2 |
| [9] | Mitnitski, A.B., Mogilner, A.J., MacKnight, C. and Rockwood, K. (2002) The Accumulation of Defects with Age and the Possible Invariance of Aging. Journal of Science World, 2, 1816-1822. https://doi.org/10.1100/tsw.2002.861 |
| [10] | Williams, B., Mancia, G., Spiering, W., et al. (2018) 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. European Heart Journal, 39, 3021-3104. https://doi.org/10.1093/eurheartj/ehy339 |
| [11] | Rockwood, K., Song, X., MacKnight, C., et al. (2005) A Global Clinical Measure of Fitness and Frailty in Elderly People. Canadian Medical Association Journal, 173, 489-495. https://doi.org/10.1503/cmaj.050051 |
| [12] | 李雪, 黄大海, 施红. 衰弱与冠心病研究进展[J]. 中华老年医学杂志, 2018, 37(4): 470-473. |
| [13] | Afilalo, J., Karunananthan, S., Eisenberg, M.J., et al. (2009) Role of Frailty in Patients with Cardiovascular Disease. The American Journal of Cardiology, 103, 1616-1621. https://doi.org/10.1016/j.amjcard.2009.01.375 |
| [14] | McNallan, S.M., Singh, M., Chamberlain, A.M., et al. (2013) Frailty and Healthcare Utilization among Patients with Heart Failure in the Community. JACC: Heart failure, 1, 135-141. https://doi.org/10.1016/j.jchf.2013.01.002 |
| [15] | Chen, W.W., Gao, R.L., Liu, L.S., Zhu, M.L., et al. (2016) Outline of the Report on Cardiovascular Diseases in China, 2014. European Heart Journal Supplements: Journal of the European Society of Cardiology, 18, F2-F11. https://doi.org/10.1093/eurheartj/suw030 |
| [16] | Ekerstad, N., Swahn, E., Janzon, M., et al. (2014) Frailty Is Independently Associated with 1-Year Mortality for Elderly Patients with Non-ST-Segment Elevation Myocardial Infarction. European Journal of Preventive Cardiology, 21, 1216-1224. https://doi.org/10.1177/2047487313490257 |
| [17] | Gharacholou, S.M., Roger, V.L., Lennon, R.J., et al. (2012) Comparison of Frail Patients versus Nonfrail Patients ≥65 Years of Age Undergoing Percutaneous Coronary Intervention. The American Journal of Cardiology, 109, 1569-1575. https://doi.org/10.1016/j.amjcard.2012.01.384 |
| [18] | 范利, 李建华, 胡亦新. 合并不同并发症的老年高血压患者的衰弱检出率[J]. 中华高血压杂志, 2015, 23(12): 1151-1155. |
| [19] | 焦莉莉, 周金锋. 老年冠心病患者衰弱的危险因素与全身性炎症反应指数的相关性分析[J]. 中国循证心血管医学杂志, 2023, 15(12): 1330-1333. |
| [20] | Cesari, M., Leeuwenburgh, C., Lauretani, F., et al. (2006) Weakness Syndrome and Skeletal Muscle: Results of the Chianti Invecchiare Study. American Journal of Clinical Nutrition, 83, 1142-1148. https://doi.org/10.1093/ajcn/83.5.1142 |
| [21] | Qu, T., Walston, J.D., Yang, H., et al. (2009) Upregulated ex vivo Expression of Stress-Responsive Inflammatory Pathway Genes by LPS-Challenged CD14 Monocytes in Frail Older Adults. Mechanisms of Ageing and Development, 130, 161-166. https://doi.org/10.1016/j.mad.2008.10.005 |
| [22] | 叶琛. 超敏C反应蛋白对急性ST段抬高心肌梗死患者心脏终点事件的预测价值[J]. 临床合理用药杂志, 2014(36): 7-8. |
| [23] | Rodondi, N., Marques-Vidal, P., Butler, J., et al. (2010) Markers of Atherosclerosis and Inflammation for Prediction of Coronary Heart Disease in Older Adults. American Journal of Epidemiology, 171, 540-549. https://doi.org/10.1093/aje/kwp428 |
| [24] | Takeuchi, O. and Akira, S. (2010) Pattern Recognition Receptors and Inflammation. Cell, 140, 805-820. https://doi.org/10.1016/j.cell.2010.01.022 |
| [25] | Kalogeropoulos, A., Georgiopoulou, V., Psaty, B.M., et al. (2010) Inflammatory Markers and Incident Heart Failure Risk in Older Adults: The Health ABC (Health, Aging, and Body Composition) Study. Journal of the American College of Cardiology, 55, 2129-2137. https://doi.org/10.1016/j.jacc.2009.12.045 |
| [26] | Leung, F.P., Yung, L.M., Laher, I., et al. (2008) Exercise, Vascular Wall and Cardiovascular Diseases: An Update (Part 1). Sports Medicine, 38, 1009-1024. https://doi.org/10.2165/00007256-2008-38120-00005 |
| [27] | Jones, T.H. (2010) Testosterone Deficiency: Risk Factors for Cardiovascular Disease? Trends in Endocrinology & Metabolism, 21, 496-503. https://doi.org/10.1016/j.tem.2010.03.002 |
| [28] | Aprahamian, I., Sasaki, E., Dos Santos, M.F., et al. (2018) Hypertension and Weakness in the Elderly. The Journal of Clinical Hypertension, 20, 186-192. https://doi.org/10.1111/jch.13135 |
| [29] | 陈雨萍, 张先庚, 曹俊. 社区老年高血压患者衰弱现状及影响因素[J]. 中国老年学杂志, 2022, 42(2): 459-462. |
| [30] | 罗健钊, 郭茹, 苏艳玲. 衰弱与高血压的最新临床研究进展[J]. 中国全科医学, 2021, 24(32): 4145-4149, 4159. https://doi.org/10.12114/j.issn.1007-9572.2021.01.307 |
| [31] | Salaffi, F., Di Carlo, M., Farah, S., et al. (2020) The Comprehensive Rheumatologic Assessment of Frailty (CRAF): Development and Validation of a Multidimensional Frailty Screening Tool in Patients with Rheumatoid Arthritis. Clinical and Experimental Rheumatology, 38, 488-499. |
| [32] | Chehrehgosha, M., Fadaye, V.R., Alizadeh, K.M., Sharifi, F., Aminalroaya, R., Vahabi, Z., et al. (2021) Role of Frailty in Prediction of Hospitalized Older Adult Patient’s Outcomes: A Prospective Study. Turkish Journal of Medical Sciences, 51, Article 12. https://doi.org/10.3906/sag-2012-332 |
| [33] | Gao, K., Li, B.-L., Yang, L., Zhou, D., Ding, K.-X., Yan, J., et al. (2021) Cardiometabolic Diseases, Frailty, and Healthcare Utilization and Expenditure in Community-Dwelling Chinese Older Adults. Scientific Reports, 11, Article No. 7776. https://doi.org/10.1038/s41598-021-87444-z |
| [34] | Kawada, T. (2021) Frailty and All-Cause Mortality in Older Adults: A Risk Assessment. Journal of the American Medical Directors Association, 22, 1774. https://doi.org/10.1016/j.jamda.2021.03.006 |
| [35] | Damluji, A.A., Chung, S.-E., Xue, Q.-L., Hasan, R.K., Walston, J.D., Forman, D.E., et al. (2021) Physical Frailty Phenotype and the Development of Geriatric Syndromes in Older Adults with Coronary Heart Disease. The American Journal of Medicine, 134, 662-671. https://doi.org/10.1016/j.amjmed.2020.09.057 |
| [36] | Yoshioka, N., Takagi, K., Morita, Y., Yoshida, R., Nagai, H., Kanzaki, Y., et al. (2019) Impact of the Clinical Frailty Scale on Mid-Term Mortality in Patients with ST-Elevated Myocardial Infarction. International Journal of Cardiology Heart & Vasculature, 22, 192-198. https://doi.org/10.1016/j.ijcha.2019.02.014 |
| [37] | Rodriguez-Ma？as, L. and Fried, L.P. (2015) Frailty in the Clinical Scenario. The Lancet, 385, E7-E9. https://doi.org/10.1016/S0140-6736(14)61595-6 |
| [38] | Kojima, G., Taniguchi, Y., Iliffe, S., Jivraj, S. and Walters, K. (2019) Transitions between Frailty States among Community-Dwelling Older People: A Systematic Review and Meta-Analysis. Ageing Research Reviews, 50, 81-88. https://doi.org/10.1016/j.arr.2019.01.010 |
| [39] | Bodolea, C., Hiriscau, E.I., Buzdugan, E.C., Grosu, A.I., Stoicescu, L., Vesa, S., et al. (2020) The Association between Peripheral Blood Cells and the Frailty Syndrome in Patients with Cardiovascular Diseases. Endocrine, Metabolic & Immune Disorders-Drug Targets, 20, 1419-1433. https://doi.org/10.2174/1871530320666200813135905 |
| [40] | Hou, P., Xue, H.-P., Mao, X.-E., Li, Y.-N., Wu, L.-F. and Liu, Y.-B. (2018) Inflammation Markers Are Associated with Frailty in Elderly Patients with Coronary Heart Disease. Aging, 10, 2636-2645. https://doi.org/10.18632/aging.101575 |
| [41] | Mailliez, A., Guilbaud, A., Puisieux, F., Dauchet, L. and Boulanger, é. (2020) Circulating Biomarkers Characterizing Physical Frailty: CRP, Hemoglobin, Albumin, 25OHD and Free Testosterone as Best Biomarkers. Results of a Meta-Analysis. Experimental Gerontology, 139, Article 111014. https://doi.org/10.1016/j.exger.2020.111014 |
| [42] | Li, C.-M., Chao, C.-T., Chen, S.-I., Han, D.-S. and Huang, K.-C. (2020) Elevated Red Cell Distribution Width Is Independently Associated with a Higher Frailty Risk among 2932 Community-Dwelling Older Adults. Frontiers in Medicine, 7, Article 470. https://doi.org/10.3389/fmed.2020.00470 |
| [43] | Tetsuka, S., Morita, M., Ikeguchi, K., et al. (2013) Creatinine/Cystatin C Ratio as a Surrogate Marker of Residual Muscle Mass in Amyotrophic Lateral Sclerosis. Neurology and Clinical Neuroscience, 1, 32-37. https://doi.org/10.1002/ncn3.11 |
| [44] | Kusunoki, H., Tsuji, S., Wada, Y., et al. (2018) Relationship between Sarcopenia and the Serum Creatinine/Cystatin C Ratio in Japanese Rural Community-Dwelling Older Adults. JCSM Clinical Reports, 3, 1-14. https://doi.org/10.17987/jcsm-cr.v3i1.57 |
| [45] | Kashani, K.B., Frazee, E.N., Kukralova, L., et al. (2017) Evaluating Muscle Mass by Using Markers of Kidney Function: Development of the Sarcopenia Index. Critical Care Medicine, 45, e23-e29. https://doi.org/10.1097/CCM.0000000000002013 |
| [46] | Hirai, K., Tanaka, A., Homma, T., et al. (2020) Serum Creatinine/Cystatin C Ratio as a Surrogate Marker for Sarcopenia in Patients with Chronic Obstructive Pulmonary Disease. Clinical Nutrition, 40, 1274-1280. https://doi.org/10.1016/j.clnu.2020.08.010 |
| [47] | Sun, J., Yang, H., Cai, W., et al. (2022) Serum Creatinine/Cystatin C Ratio as a Surrogate Marker for Sarcopenia in Patients with Gastric Cancer. BMC Gastroenterology, 22, Article No. 26. https://doi.org/10.1186/s12876-022-02093-4 |
