目的 评价白细胞总数、血红蛋白、生化指标、红细胞沉降率、免疫球蛋白(Ig)水平对80岁及以上患者死亡的远期预后价值. 方法 对342例常规查体的老人进行随访,年龄80～94岁,平均(85.6±4.0)岁,随访2～119个月,平均(82.0±36.9)个月,记录死亡原因和死亡.时间.结果 与存活组(132例)比较,死亡组(198例)年龄大,分别为(86.5±4.4)岁与(84.5±3.2)岁(t=-4.86,P＜0.01),白细胞总数高[(6.2±1.7)×109/L比(5.5±1.3)×109/L,t=-3.93,P＜0.01],血红蛋白低[ (134.4±14.4)g/L比(140.0±12.6)g/L,t=3.65,P＜0.001],红细胞沉降率快[中位数为11 mm/h(四分位数间距为15 mm/h)比中位数为9 mm/h(四分位数间距为10 mm/h),U=-3.31,P＜0.01],IgM低[(0.9±0.5)mg/L比(1.1±0.8)mg/L,t=2.55,P＜0.05],尿素稍高[(7.5±2.6) mmol/L比(6.8±1.6) mmol/L,t=2.81,P＜0.01],肌酐高[(113.0±32.5)μmol/L比(100.5±15.8) μmol/L,t=-4.65,P＜0.01].Cox多元回归分析结果显示,年龄(RR=1.083,95％CI为1.040～1.127,P＜0.01)、血红蛋白(RR=0.835,95％CI为0.714～0.975,P＜0.05)、白细胞总数(RR=1.134,95％ CI为1.021～1.260,P＜0.05)、IgM(RR=0.710,95％CI为0.521～0.966,P＜0.05)、肌酐(RR=1.011,95％ CI为1.002～1.020,P＜0.05)、主动脉瘤(RR=2.144,95％CI为1.163～3.951,P＜0.05)是预测80岁及以上患者死亡的独立危险因子. 结论 在80岁及以上患者中,年龄增加、白细胞总数升高、血红蛋白降低、IgM降低、肌酐升高、并存主动脉瘤是全因死亡的独立危险因素,对于80岁及以上患者预后判断有一定的临床意义.
目的 評價白細胞總數、血紅蛋白、生化指標、紅細胞沉降率、免疫毬蛋白(Ig)水平對80歲及以上患者死亡的遠期預後價值. 方法 對342例常規查體的老人進行隨訪,年齡80～94歲,平均(85.6±4.0)歲,隨訪2～119箇月,平均(82.0±36.9)箇月,記錄死亡原因和死亡.時間.結果 與存活組(132例)比較,死亡組(198例)年齡大,分彆為(86.5±4.4)歲與(84.5±3.2)歲(t=-4.86,P＜0.01),白細胞總數高[(6.2±1.7)×109/L比(5.5±1.3)×109/L,t=-3.93,P＜0.01],血紅蛋白低[ (134.4±14.4)g/L比(140.0±12.6)g/L,t=3.65,P＜0.001],紅細胞沉降率快[中位數為11 mm/h(四分位數間距為15 mm/h)比中位數為9 mm/h(四分位數間距為10 mm/h),U=-3.31,P＜0.01],IgM低[(0.9±0.5)mg/L比(1.1±0.8)mg/L,t=2.55,P＜0.05],尿素稍高[(7.5±2.6) mmol/L比(6.8±1.6) mmol/L,t=2.81,P＜0.01],肌酐高[(113.0±32.5)μmol/L比(100.5±15.8) μmol/L,t=-4.65,P＜0.01].Cox多元迴歸分析結果顯示,年齡(RR=1.083,95％CI為1.040～1.127,P＜0.01)、血紅蛋白(RR=0.835,95％CI為0.714～0.975,P＜0.05)、白細胞總數(RR=1.134,95％ CI為1.021～1.260,P＜0.05)、IgM(RR=0.710,95％CI為0.521～0.966,P＜0.05)、肌酐(RR=1.011,95％ CI為1.002～1.020,P＜0.05)、主動脈瘤(RR=2.144,95％CI為1.163～3.951,P＜0.05)是預測80歲及以上患者死亡的獨立危險因子. 結論 在80歲及以上患者中,年齡增加、白細胞總數升高、血紅蛋白降低、IgM降低、肌酐升高、併存主動脈瘤是全因死亡的獨立危險因素,對于80歲及以上患者預後判斷有一定的臨床意義.
목적 평개백세포총수、혈홍단백、생화지표、홍세포침강솔、면역구단백(Ig)수평대80세급이상환자사망적원기예후개치. 방법 대342례상규사체적노인진행수방,년령80～94세,평균(85.6±4.0)세,수방2～119개월,평균(82.0±36.9)개월,기록사망원인화사망.시간.결과 여존활조(132례)비교,사망조(198례)년령대,분별위(86.5±4.4)세여(84.5±3.2)세(t=-4.86,P＜0.01),백세포총수고[(6.2±1.7)×109/L비(5.5±1.3)×109/L,t=-3.93,P＜0.01],혈홍단백저[ (134.4±14.4)g/L비(140.0±12.6)g/L,t=3.65,P＜0.001],홍세포침강솔쾌[중위수위11 mm/h(사분위수간거위15 mm/h)비중위수위9 mm/h(사분위수간거위10 mm/h),U=-3.31,P＜0.01],IgM저[(0.9±0.5)mg/L비(1.1±0.8)mg/L,t=2.55,P＜0.05],뇨소초고[(7.5±2.6) mmol/L비(6.8±1.6) mmol/L,t=2.81,P＜0.01],기항고[(113.0±32.5)μmol/L비(100.5±15.8) μmol/L,t=-4.65,P＜0.01].Cox다원회귀분석결과현시,년령(RR=1.083,95％CI위1.040～1.127,P＜0.01)、혈홍단백(RR=0.835,95％CI위0.714～0.975,P＜0.05)、백세포총수(RR=1.134,95％ CI위1.021～1.260,P＜0.05)、IgM(RR=0.710,95％CI위0.521～0.966,P＜0.05)、기항(RR=1.011,95％ CI위1.002～1.020,P＜0.05)、주동맥류(RR=2.144,95％CI위1.163～3.951,P＜0.05)시예측80세급이상환자사망적독립위험인자. 결론 재80세급이상환자중,년령증가、백세포총수승고、혈홍단백강저、IgM강저、기항승고、병존주동맥류시전인사망적독립위험인소,대우80세급이상환자예후판단유일정적림상의의.
Objective To evaluate the prognostic values of leukocyte count,hemoglobin,biochemical parameters,erythrocyte sedimentation rate and immunoglobulin on mortality in patients aged 80 years and over.Methods Totally 342 patients(aged 85.6±4.0 years)were followed up for (82.0±36.9) months,and the cause and time of death were recorded.Results During the period of follow up,198 patients suffered from death.Compared with the survival group (132 cases),the death group had older age [ (86.5±4.4)years vs.(84.5±3.2)years,t=-4.86,P＜0.01 ],higher white blood cell [ (6.2± 1.7) ＞ 109/L vs.(5.5±1.3) × 109/L,t=-3.93,P＜0.01 ],lower hemoglobin [(134.4±14.4)g/L vs.(140.0± 12.6)g/L,t= 3.65,P＜0.01 ],slightly faster erythrocyte sedimentation rate [ 11 mm/h(15 mm/h) vs.9 mm/h (10 mm/h),U=- 3.31,P＜0.01 ],lower immunoglobulin M [ (0.9±0.5)mg/L vs.(1.1±0.8)mg/L,t =2.55,P＜0.05 ],slightly higher urea nitrogen [ (7.5±2.6) mmol/L vs.(6.8±1.6) mmol/L,t=2.81,P＜0.01]and creatinine [(113.0±32.5) μmol/L vs.(100.5±15.8) μmol/L,t=-4.65,P＜0.01 ].Cox multivariate analysis revealed that older age (RR=1.083,95％CI:1.040 1.127,P＜0.01),white blood cell count (RR=1.134,95％CI:1.021-1.260,P＜0.05),creatinine (RR=1.011,95％CI=1.0021.020,P＜0.05),hemoglobin(RR=0.835,95％CI:0.714-0.975,P＜0.05)andimmunoglobulin M(RR=0.710,95％CI:0.521-0.966,P＜0.03),aorticaneurysm(RR=2.144,95％CI:1.163-3.951,P ＜ 0.05 ) were the independent risk factors for death.Conclusions Aging,increased WBC count,decreased hemoglobin and immunoglobulin M,elevated creatinine and aortic aneurysm are the independent risk factors for death,which are powerful parameters for the prognostic evaluation in the elderly aged 80 years and over.
