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| 综合评估干预对老年骨质疏松症合并肌少症预后的影响 |
| Comprehensive evaluation of the effect of intervention on the prognosis of senile osteoporosis with sarcopenia |
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| DOI：10.3969/j.issn.1006-7108.2026.07.007 |
| 中文关键词: 老年综合评估 骨质疏松症 肌少症 干预管理 生活质量 |
| 英文关键词:geriatric comprehensive assessment osteoporosis sarcopenia intervention management quality of life |
| 基金项目:山东省医药卫生科技项目（2023BJ000002）；山东省自然科学基金资助项目（ZR2024QH130） |
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| 中文摘要: |
| 目的 旨在研究基于老年综合评估（comprehensive geriatric assessment，CGA）的干预方案对老年骨质疏松症（osteoporosis，OP）合并肌少症患者的影响，为老年OP合并肌少症的防治提供理论依据。方法 选择2023年1月至2024年12月于日照市人民医院老年医学科就诊的160例老年OP合并肌少症患者，完成骨密度（bone mineral density，BMD）、血清骨代谢指标检测、肌少症评估及CGA筛查后，分为对照组和干预组，每组80例，对照组实施常规管理措施，干预组应用基于CGA的干预管理策略，比较两组患者管理前及管理1年后骨代谢指标、BMD、骨骼肌质量指数（appendicular skeletal muscle mass index，ASMI）、握力、6 m步速、管理期间跌倒与骨折发生率及CGA评估量表变化。结果 管理1年后，干预组的血清25(OH)D水平、BMD均较对照组显著提高（P＜0.05），血清OC、PINP及CTX水平较对照组均显著下降（P＜0.05）。干预组ASMI、6 m步速、握力及CAG评估量表均较干预前及对照组干预后均明显改善（P＜0.05）；干预组在管理期间跌倒与骨折的发生率较对照组均显著降低（P＜0.05）。结论 基于CGA的干预管理能有效改善老年OP合并肌少症患者的骨代谢指标、增加BMD、改善肌肉质量、减少跌倒与骨折发生率，全面提升老年患者功能状态及生活质量。 |
| 英文摘要: |
| Objective To explore the effect of intervention program based on Comprehensive geriatric assessment (CGA) in elderly patients with osteoporosis (OP) combined with sarcopenia, and provide theoretical basis for the prevention and treatment of OP combined with sarcopenia. Methods A total of 160 elderly patients with OP complicated with sarcopenia were selected from the Geriatric Medicine Department of Rizhao People's Hospital from January 2023 to December 2024. All the research subjects underwent bone mineral density (BMD), serum bone metabolism index detection, sarcopenia assessment and CGA screening as the research subjects. They were divided into the control group and the intervention group (80 cases each). The control group was given conventional management measures, while the intervention group was provided with an intervention management strategy based on CGA. According to the data type, Paired t-test, Wilcoxon rank sum test or χ2 test were respectively used to compare the bone metabolism indicators, BMD, appendicular skeletal muscle mass index (ASMI), grip strength, 6-meter walking speed and changes of the CGA assessment scale in the two groups of patients before management and one year after management, and the incidence of falls and fractures during management. Results After one year of management, the levels of serum 25 (OH) D and BMD in the intervention group increased significantly after interventions compared to the control group (P < 0.05), while the levels of serum OC, PINP and CTX were significantly lower than that of the control group (P < 0.05). The ASMI, 6-meter walking speed, grip strength and CAG assessment scale in the intervention group were significantly improved compared with those before the intervention and those in the control group after the intervention (P < 0.05). The incidence of falls and fractures in the intervention group during the management period was lower than that in the control group (P <0.05). Conclusion The application of CGA-based intervention program in elderly OP patients with sarcopenia can improve the bone metabolism indexes of patients, increase BMD, improve muscle mass, reduce the incidence of falls and fractures, comprehensively improve the functional status of patients, and improve the quality of life. |
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