护理学报 ›› 2018, Vol. 25 ›› Issue (21): 19-23.doi: 10.16460/j.issn1008-9969.2018.21.019
陆柳营, 陈玲, 杨永, 傅桂芬, 韦玉娟, 王文广, 涂燕玉, 杨连招
摘要: 目的 对原发性老年高血压合并衰弱的研究进展进行综述,为临床开展相关研究以及制定科学的干预策略提供参考。方法 检索国内外文献,从原发性老年高血压与衰弱的关系、筛查和评估、护理干预3个方面进行分析。结果 衰弱概念的引入拓宽了原发性老年高血压的护理实践范围,很多证据均支持衰弱会增加原发性老年高血压患者血压管理的复杂性,而早期识别和干预衰弱,可减少或延缓原发性老年高血压患者不良健康结局的发生,改善预后。结论 目前,关于原发性老年高血压合并衰弱的干预性研究不多,缺乏统一的衰弱筛查和评估标准,原发性老年高血压与衰弱的关系仍不十分明确,还需进一步验证。有必要深入探索相应的更科学的护理干预策略。
中图分类号:
[1] Clegg A, Young J, Iliffe S, et al.Frailty in Elderly People[J]. Lancet, 2013,381(9868):752-762.DOI:10.1016/S0140-6736(12)62167-9. [2] 王燕秋,韩斌如.衰弱表型定义对老年人不良结局预警的研究进展[J].护理学报,2015,22(14):20-23.DOI:10.16460/j.issn1008-9969.2015.14.020. [3] 邹红,孙婷,沈晓君,等.加强健康管理对老年高血压患者依从性和生活质量的影响[J].护理学报,2013,20(14):73-75. [4] 戴伦. 重视老年高血压相关性心血管病与衰弱并存患者的防治管理[J].中华高血压杂志,2017, 25(9):818-822. DOI:10.16439/j.cnki.1673-7245.2017.09.006. [5] 范利. 老年高血压合并衰弱的管理任重道远[J].中华老年多器官疾病杂志,2018, 17(5):321-323.DOI:10.11915/j.issn.1671-5403.2018.05.071. [6] Kang Min-Gu, Kim Sun-Wook, Yoon Sol-Ji, et al.Association between Frailty and Hypertension Prevalence, Treatment, and Control in the Elderly Korean Population[J]. Sci Rep,2017,7(1):7542. DOI:10.1038/s41598-017-07449-5. [7] Castrejón-Pérez R C, Gutiérrez-Robledo L M, Cesari M, et al. Diabetes Mellitus, Hypertension and Frailty: A Population-based, Cross-sectional Study of Mexican Older Adults[J]. Geriatr Gerontol Int,2017,17(6):925-930. DOI:10.1111/ggi.12805. [8] 范利,李建华,胡亦新,等.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. DOI:10.16439/j.cnki.1673-7245.2015.12.018. [9] 郝秋奎,李峻,董碧蓉,等.老年患者衰弱评估与干预中国专家共识[J].中华老年医学杂志,2017, 36(3):251-256. DOI:10.3760/cma.j.issn.0254-9026.2017.03.007. [10] Vaes B, Depoortere D, Van Pottelbergh G, et al.Association between Traditional Cardiovascular Risk Factors and Mortality in the Oldest Old: Untangling the Role of Frailty[J]. BMC Geriatr, 2017,17(1):234.DOI:10.1186/s12877-017-0626-x. [11] Warwick J, Falaschetti E, Rockwood K, et al.No Evidence that Frailty Modifies the Positive Impact of Antihypertensive Treatment in very Elderly People: An Investigation of the Impact of Frailty upon Treatment Effect in the Hypertension in the Very Elderly Trial(HYVET) Study, a Double-blind,Placebo-controlled Study of Antihypertensives in People with Hypertension Aged 80 and Over[J]. BMC Med, 2015,13:78. DOI:10.1186/s12916-015-0328-1. [12] Pajewski N M, Williamson J D, Applegate W B,et al.Characterizing Frailty Status in the Systolic Blood Pressure Intervention Trial[J]. J Gerontol A Biol Sci Med Sci, 2016,71(5):649-655. DOI:10.1093/gerona/glv228. [13] 马丽娜. 衰弱与老年人心血管病的关系[J].中华高血压杂志,2017,25(4):384-387. DOI:10.16439/j.cnki.1673-7245.2017.04.018. [14] Bromfield S G, Ngameni C A, Colantonio L D, et al.Blood Pressure, Antihypertensive Polypharmacy, Frailty, and Risk for Serious Fall Injuries among Older Treated Adults with Hypertension[J]. Hypertension, 2017,70(2):259-266. DOI: 10.1161/HYPERTENSIONAHA.116.09390. [15] 李建华,范利,赵婷,等.老年高血压患者发生衰弱对预后的影响[J].中华老年多器官疾病杂志,2018,17(5):324-328. DOI:10.11915/j.issn.1671-5403.2018.05.072. [16] Odden M C, Peralta C A,Haan M N, et al.Rethinking the Association of High Blood Pressure with Mortality in Elderly Adults[J]. Arch Intern Med, 2012,172(15):1162-1168. DOI:10.1001/archinternmed.2012.2555. [17] Odden M C, Covinsky K E, Neuhaus J M, et al.The Association of Blood Pressure and Mortality Differs by Self-reported Walking Speed in Older Latinos[J]. J Gerontol A Biol Sci Med Sci,2012,67(9):977-983. DOI:10.1093/gerona/glr245. [18] Wu C, Smit E, Peralta C A, et al.Functional Status Modifies the Association of Blood Pressure with Death in Elders: Health and Retirement Study[J]. J Am Geriatr Soc,2017,65(7):1482-1489. DOI:10.1111/jgs.14816. [19] Jankowska-Polańska B, Dudek K, Szymanska-Chabowska A, et al.The Influence of Frailty Syndrome on Medication Adherence among Elderly Patients with Hypertension[J]. Clin Interv Aging, 2016,11:1781-1790. DOI:10.2147/CIA.S113994. [20] Chudiak A, Jankowska-Polańska B, Uchmanowicz I.Effect of Frailty Syndrome on Treatment Compliance in Older Hypertensive Patients[J]. Clin Interv Aging, 2017, 12:805-814. DOI:10.2147/CIA.S126526. [21] Jankowska-Polańska B, Zamęta K, Uchmanowicz I, et al.Adherence to Pharmacological and Non-pharmacological Treatment of Frail Hypertensive Patients[J]. J Geriatr Cardiol,2018,15(2):153-161.DOI:10.11909/j.issn.1671-5411.2018.02.002. [22] 杨丽峰,杨洋,张春梅,等.老年人衰弱评估量表的编制及信效度检验[J].中华护理杂志,2017,52(1):49-53. DOI:10.3761/j.issn.0254-1769.2017.01.010. [23] Theou O, Brothers T D, Pena F G,et al.Identifying Common Characteristics of Frailty Across Seven Scales[J]. Am Geriatr Soc, 2014,62(5):901-906. DOI:10.1111/jgs.12773. [24] Theou O, Brothers T D, Mitnitski A, et al.Operation Alization of Frailty Using Eight Commonly Used Scales and Comparison of Their Ability to Predict All-cause Mortality[J]. Arch Gerontol Geriatr, 2013,61(9):1537-1551. DOI:10.1111/jgs.12420. [25] Fried L P, Tangen C M, Walston J, et al.Frailty in Older Adults: Evidence for a Phenotype[J]. J Gerontol A Biol Sci Med Sci, 2001,56(3):M146-M156. [26] Vermeulen J, Neyens JC, van Rossum E, et al. Predicting ADL Disability in Community-dwelling Elderly People Using Physical Frailty Indicators: A Systematic Review[J]. BMC Geriatr, 2011,11:33. [27] 奚兴,郭桂芳,孙静.老年人衰弱评估工具及其应用研究进展[J].中国老年学杂志,2015,35(20):5993-5996. DOI:10.3969/j.issn.1005-9202.2015.20.153. [28] Gobbens R J, van Assen M A, Luijkx K G, et al. Testing an Integral Conceptual Model of Frailty[J]. J Adv Nurs, 2012,68(9):2047-2060. DOI:10.1111/j.1365-2648.2011.05896.x. [29] 奚兴,郭桂芳,孙静.中文版Tilburg衰弱评估量表的信效度研究[J].护理学报,2013,20(8B):1-5.DOI:10.16460/j.issn1008-9969.2013.16.006. [30] 李菲,刘慧松,查龙肖,等.中文版老年人衰弱评估量表的修订和信效度评价[J].护理学杂志,2017,32(7):18-20. DOI:10.3870/j.issn.1001-4152.2017.07.018. [31] Benetos A, Bulpitt C J Petrovic M, et al. An Expert Opinion from the European Society of Hypertension-European Union Geriatric Medicine Society Working Group on the Management of Hypertension in very Old,Frail Subjects[J]. Hypertension, 2016,67(5):820-825. DOI:10.1161/HYPERTENSIONAHA.115.07020. [32] 宋永嘉,郑吉元,李泽佳,等.传统运动疗法在现代慢性病防治中的应用价值[J].中医药临床杂志,2015, 27(4):462-464. DOI:10.16448/j.cjtcm.2015.0171. [33] Jadczak A D, Makwana N, Luscombe-Marsh, et al.Effectiveness of Exercise Interventions on Physical Function in Community-dwelling Frail Older People: An Umbrella Review of Systematic Reviews[J]. JBI Database System Rev Implement Rep, 2018,16(3):752-775. DOI:10.11124/JBISRIR-2017-003551. [34] Theou O, Stathokostas L, Roland P, et al.The Effectiveness of Exercise Interventions Forthe Management of Frailty: A Systematic Review[J]. J Aging Res, 2011(4):569194. DOI: 10.4061/2011/569194. [35] Dent E, Lien C, Lim WS, et al.The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty[J]. J Am Med Dir Assoc, 2017,18(7):564-575.DOI:10.1016/j.jamda.2017.04.018. [36] 蔡建. 抗阻训练对高血压患者自主神经功能的影响[J].山东体育科技, 2014, 36(5):83-86.DOI:10.16448/j.cjtcm.2015.0171. [37] 肖刘,锋张,亚星,等.有氧运动加弹力带对正常高值血压人群血压及心血管病危险因素的干预[J].中国疗养医学,2014,23(10):869-871. DOI:10.13517/j.cnki.ccm.2014.10.003. [38] 奚兴,郭桂芳.非药物干预改善社区老年人衰弱状况的研究进展[J].中国护理管理,2016,16(11):1461-1465. DOI: 10.3969/j.issn.1672-1756.2016.11.006. [39] Dickinson J M, Gundermann D M, Walker D K, et al.Leucineenriched Amino Acid Ingestion after Resistance Exercise Prolongs Myofibrillar Protein Synthesis and Amino Acid Transporter Expression in Older Men[J]. J Nutr, 2014,144(11):1694-1702. DOI:10.3945/jn.114.198671. [40] Fernandes A L, Hayashi A P, Jambassi-Filho J C, et al. Different Protein and Derivatives Supplementation Strategies Combined with Resistance Training in Pre-frail and Frail Elderly: Rationale and Protocol for the “Proelderly” Study[J]. Nutr Health, 2017,23(4):251-260.DOI:10.1177/0260106017737465. [41] Abizanda P, López M D, García V P, et al. Effects of an Oral Nutritional Supplementation Plus Physical Exercise Intervention on the Physical Function, Nutritional Status,Quality of Life in Frail Institutionalized Older Adults: The ACTIVNES Study[J]. J Am Med Dir Assoc, 2015,16(5):439.e9-439.e16. DOI:10.1016/j.jamda.2015.02.005. [42] 刘长虎,胡松,毛拥军,等.老年人衰弱的研究进展[J].中国全科医学,2017,20(16):2025-2033. DOI:10.3969/j.issn.1007-9572.2017.16.024. [43] Veninšek G, Gabrovec B.Management of Frailty at Individual Level-clinical Management: Systematic Literature Review[J]. Slovenian Journal of Public Health, 2018, 57(2):106-115. DOI:10.2478/sjph-2018-0014. |
[1] | 郭林芳, 张培莉, 侯晓雅, 李滢, 曹敏, 高超越. 肝癌化疗患者线上线下结合营养干预方案的构建[J]. 护理学报, 2025, 32(4): 1-5. |
[2] | 杜易梅, 刘莉, 郭立丽, 卢吉, 付苗苗, 刘杰. 妇科恶性肿瘤患者性健康研究进展[J]. 护理学报, 2025, 32(4): 28-33. |
[3] | 李垚, 陈小敏, 夏敏, 吴茜, 张琳, 陈叡喆, 葛莉丽, 吴逸梅. 肿瘤患者衰弱评估工具应用的范围综述[J]. 护理学报, 2025, 32(4): 48-52. |
[4] | 焦雪萍, 王志稳, 韩舒羽. ICU老年患者躁动行为的干预研究进展[J]. 护理学报, 2025, 32(3): 38-42. |
[5] | 杨蓓, 叶红芳, 张宁, 相卢伟, 路诗雨. 老年2型糖尿病患者体力活动现状及影响因素研究[J]. 护理学报, 2025, 32(2): 7-12. |
[6] | 陈玉英, 王海彦, 陈思颖, 杨雪娟. 老年人自立支援照护模式的照护技巧及启示[J]. 护理学报, 2025, 32(2): 31-36. |
[7] | 夏碧芸, 陈瑜, 吴彦妍, 胡雁. 降低经桡动脉冠状动脉介入术后老年患者桡动脉闭塞发生的循证实践[J]. 护理学报, 2025, 32(2): 37-43. |
[8] | 刘硕怡, 熊莉娟, 李凌, 王玉梅, 何嘉, 李鑫, 袁淑蕾, 郭雪琴, 王暘婧, 张慧娟. 老年住院患者衰弱预防及管理临床实践指南的质量评价及内容分析[J]. 护理学报, 2025, 32(2): 50-55. |
[9] | 闫亚铃, 乐美妮, 姚桃琴, 王雪莲, 姜建玲, 辛艺. 老年胃肠肿瘤患者围手术期衰弱管理方案的构建[J]. 护理学报, 2025, 32(2): 74-78. |
[10] | 王进波, 吴姗, 黄蓉蓉, 陈代凤, 洪梅, 李审绥. 头颈癌患者自杀影响因素及干预的研究进展[J]. 护理学报, 2025, 32(1): 39-43. |
[11] | 李珂, 贺雨琼, 李雨蔚, 常颖. 脑卒中患者跌倒恐惧干预研究的范围综述[J]. 护理学报, 2025, 32(1): 50-55. |
[12] | 谭丘羽, 邓一芯, 冀婉倩, 王冬华. 农村老年人自我刻板化与主观记忆抱怨在自我感知老化与痴呆恐惧间的链式中介效应[J]. 护理学报, 2025, 32(1): 56-61. |
[13] | 李雯欣, 涂惠, 张娜, 陈祎慧, 谢丽丽, 于浪琴. 运动干预改善心血管病患者运动恐惧的研究进展[J]. 护理学报, 2024, 31(9): 24-27. |
[14] | 丁心舒, 孙乐菲, 高伟, 鲁琦, 闫畅, 刘德山. 矛盾年龄歧视量表在社区老年人中的信效度检验[J]. 护理学报, 2024, 31(7): 12-16. |
[15] | 朱心悦, 嵇冰聪, 蓝雪芬, 季晓珍. 糖尿病患者电子健康素养研究进展[J]. 护理学报, 2024, 31(7): 36-39. |
|