切换至 "中华医学电子期刊资源库"

中华老年病研究电子杂志 ›› 2025, Vol. 12 ›› Issue (01) : 1 -6. doi: 10.3760/cma.j.issn.2095-8757.2025.01.001

衰弱

慢性阻塞性肺疾病合并衰弱的研究进展
戴子喻1, 谢斌1, 吴院波1, 陈琼1,()   
  1. 1. 410008 长沙,中南大学湘雅医院老年医学科 国家老年疾病临床医学研究中心(湘雅医院)
  • 收稿日期:2024-11-24 出版日期:2025-02-28
  • 通信作者: 陈琼
  • 基金资助:
    国家自然科学基金项目(82370055)中南大学研究生自主探索创新项目(2024ZZTS0171)

Research progress on chronic obstructive pulmonary disease complicated with frailty

Ziyu Dai1, Bin Xie1, Yuanbo Wu1, Qiong Chen1,()   

  1. 1. Department of Geriatrics, Xiangya Hospital, Central South University,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University,Changsha 410008, China
  • Received:2024-11-24 Published:2025-02-28
  • Corresponding author: Qiong Chen
引用本文:

戴子喻, 谢斌, 吴院波, 陈琼. 慢性阻塞性肺疾病合并衰弱的研究进展[J/OL]. 中华老年病研究电子杂志, 2025, 12(01): 1-6.

Ziyu Dai, Bin Xie, Yuanbo Wu, Qiong Chen. Research progress on chronic obstructive pulmonary disease complicated with frailty[J/OL]. Chinese Journal of Geriatrics Research(Electronic Edition), 2025, 12(01): 1-6.

衰弱是慢性阻塞性肺疾病(COPD)患者常见的共病之一。COPD患者存在的慢性炎症反应、氧化应激失衡、肠道菌群失调等均参与了衰弱的病理生理过程,老年患者更容易合并衰弱状态,增加了不良临床结局的发生风险。文章现就COPD合并衰弱的流行病学特征、危险因素、发病机制、评估与干预策略的研究进展进行综述,以期为临床诊治提供参考。

Frailty is a common comorbidity among patients with chronic obstructive pulmonary disease (COPD). Chronic inflammatory responses, oxidative stress imbalance, and gut microbiota dysbiosis induced by COPD collectively contribute to the pathophysiological processes underlying frailty in these patients. COPD patients, particularly elderly individuals, are more prone to developing frailty syndrome, thereby significantly increasing their risk of adverse clinical outcomes. This article provides a comprehensive review of recent research advances in the epidemiological characteristics, risk factors,possible pathogenic mechanisms, assessment methods, and intervention strategies for COPD complicated by frailty syndrome, in order to provide a reference for clinical diagnosis and treatment.

[1]
Global strategy for prevention, diagnosis and management of COPD: 2023 Report[EB/OL]. [2024-10-15]. https://goldcopd.org/2023-gold-report-2/.
[2]
Chronic obstructive pulmonary disease in over 16s: Diagnosis and management[EB/OL].[2024-10-15]. https://www.nice.org.uk/guidance/ng115.
[3]
Hanlon P, Guo X, McGhee E, et al. Systematic review and metaanalysis of prevalence, trajectories, and clinical outcomes for frailty in COPD[J]. NPJ Prim Care Respir Med, 2023, 33(1):1.
[4]
Verduri A, Carter B, Laraman J, et al. Frailty and its influence on mortality and morbidity in COPD: A systematic review and metaanalysis[J]. Intern Emerg Med, 2023, 18(8):2423-2434.
[5]
黎娇,谢静茹,王光霞.老年慢性阻塞性肺疾病患者衰弱危险因素分析及其与氧化应激的相关性[J].中国基层医药,2024,31(5):681-685.
[6]
Kennedy CC, Novotny PJ, LeBrasseur NK, et al. Frailty and clinical outcomes in chronic obstructive pulmonary disease[J].Ann Am Thorac Soc, 2019, 16(2):217-224.
[7]
Luo J, Zhang D, Tang W, et al. Impact of frailty on the risk of exacerbations and all-cause mortality in elderly patients with stable chronic obstructive pulmonary disease[J]. Clin Interv Aging,2021, 16:593-601.
[8]
Lahousse L, Ziere G, Verlinden VJ, et al. Risk of frailty in elderly with COPD: A population-based study[J]. J Gerontol A Biol Sci Med Sci, 2016, 71(5):689-695.
[9]
Ushida K, Shimizu A, Hori S, et al. Hospital frailty risk score predicts outcomes in chronic obstructive pulmonary disease exacerbations[J]. Arch Gerontol Geriatr, 2022, 100:104658.
[10]
Bone AE, Hepgul N, Kon S, et al. Sarcopenia and frailty in chronic respiratory disease[J]. Chron Respir Dis, 2017, 14(1):85-99.
[11]
Limpawattana P, Putraveephong S, Inthasuwan P, et al. Frailty syndrome in ambulatory patients with COPD[J]. Int J Chron Obstruct Pulmon Dis, 2017, 12:1193-1198.
[12]
Neumannova K, Slachtova M, Dupalova D, et al. Frail patients with COPD (grade 2/group B) are at higher risk of falls than nonfrail patients with the same disease severity[J]. Eur Respir J, 2019,54(suppl 63):PA1207.
[13]
Bergman H, Ferrucci L, Guralnik J, et al. Frailty: An emerging research and clinical paradigm--issues and controversies[J]. J Gerontol A Biol Sci Med Sci, 2007, 62(7):731-737.
[14]
Kojima G, Iliffe S, Walters K. Smoking as a predictor of frailty: A systematic review[J]. BMC Geriatr, 2015, 15:131.
[15]
Kojima G, Iliffe S, Jivraj S, et al. Does current smoking predict future frailty? The English longitudinal study of ageing[J]. Age Ageing, 2018, 47(1):126-131.
[16]
Guo X, Tang P, Zhang L, et al. Tobacco and alcohol consumption and the risk of frailty and falling: A Mendelian randomisation study[J]. J Epidemiol Community Health, 2023, 77(6):349-354.
[17]
Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD[J]. Eur Respir J, 2009, 33(5):1165-1185.
[18]
Martinot P, Landré B, Zins M, et al. Association between potentially inappropriate medications and frailty in the early old age: A longitudinal study in the GAZEL Cohort[J]. J Am Med Dir Assoc, 2018, 19(11):967-973.e3.
[19]
Yan LC, Lu HY, Wang XY, et al. Prevalence and risk factors of frailty in patients with chronic obstructive pulmonary disease:Systematic review and meta-analysis[J]. Eur Geriatr Med, 2023,14(4):789-802.
[20]
Keely S, Talley NJ, Hansbro PM. Pulmonary-intestinal cross-talk in mucosal inflammatory disease[J]. Mucosal Immunol, 2012,5(1):7-18.
[21]
Yanbaeva DG, Dentener MA, Spruit MA, et al. IL6 and CRP haplotypes are associated with COPD risk and systemic inflammation: A case-control study[J]. BMC Med Genet, 2009,10:23.
[22]
Henrot P, Dupin I, Schilfarth P, et al. Main pathogenic mechanisms and recent advances in COPD peripheral skeletal muscle wasting[J]. Int J Mol Sci, 2023, 24(7):6454.
[23]
Soysal P, Stubbs B, Lucato P, et al. Inflammation and frailty in the elderly: A systematic review and meta-analysis[J]. Ageing Res Rev, 2016, 31:1-8.
[24]
Singh R, Narang M, Dawson L, et al. Could disease severity and inflammatory markers (IL-6, Hs-CRP, TNF-α) be related to frailty in COPD? A prospective study[J]. J Assoc Physicians India, 2022,70(4):11-12.
[25]
Barnes PJ. Oxidative stress in chronic obstructive pulmonary disease[J]. Antioxidants (Basel), 2022, 11(5):965.
[26]
He X, Lin X, He B, et al. Association between oxidative balance score and frailty in chronic obstructive pulmonary disease[J].Heliyon, 2024, 10(4):e25750.
[27]
Takahashi S, Hirano T, Yasuda K, et al. Impact of frailty on hippocampal volume in patients with chronic obstructive pulmonary disease[J]. Biomedicines, 2021, 9(9):1103.
[28]
Fukatsu-Chikumoto A, Hirano T, Takahashi S, et al. Correlation between frailty and reduction in cortical thickness in patients with chronic obstructive pulmonary disease[J]. Sci Rep, 2024,14(1):6106.
[29]
Wang XM, Fan L, Meng CC, et al. Gut microbiota influence frailty syndrome in older adults: Mechanisms and therapeutic strategies[J]. Biogerontology, 2024, 25(1):107-129.
[30]
Jarmukhanov Z, Mukhanbetzhanov N, Vinogradova E, et al. Gut metagenomic features of frailty[J]. Front Cell Infect Microbiol,2024, 14:1486579.
[31]
Li N, Dai Z, Wang Z, et al. Gut microbiota dysbiosis contributes to the development of chronic obstructive pulmonary disease[J].Respir Res, 2021, 22(1):274.
[32]
Li N, Wang N, Ran P. Gut microbiota dysbiosis and chronic obstructive pulmonary disease: A question of chicken and egg[J].Am J Respir Crit Care Med, 2023, 208(11):1238-1240.
[33]
Osadnik CR, Brighton LJ, Burtin C, et al. European respiratory society statement on frailty in adults with chronic lung disease[J].Eur Respir J, 2023, 62(2):2300442 [pii].
[34]
Fried LP, Tangen CM, Walston J, et al. Frailty in older adults:Evidence for a phenotype[J]. J Gerontol A Biol Sci Med Sci, 2001,56(3):M146-156.
[35]
Abellan van Kan G, Rolland YM, Morley JE, et al. Frailty: Toward a clinical definition[J]. J Am Med Dir Assoc, 2008, 9(2):71-72.
[36]
Brighton LJ, Nolan CM, Barker RE, et al. Frailty and mortality risk in COPD: A cohort study comparing the fried frailty phenotype and short physical performance battery[J]. Int J Chron Obstruct Pulmon Dis, 2023, 18:57-67.
[37]
Chin M, Kendzerska T, Inoue J, et al. Comparing the hospital frailty risk score and the clinical frailty scale among older adults with chronic obstructive pulmonary disease exacerbation[J].JAMA Netw Open, 2023, 6(2):e2253692.
[38]
Li M, She Q, Tu J, et al. Association of frailty with clinical outcomes in chronic obstructive pulmonary disease: A retrospective longitudinal cohort study[J]. Heliyon, 2023,9(5):e15764..
[39]
Albarrati AM, Gale NS, Munnery MM, et al. The timed up and go test predicts frailty in patients with COPD[J]. NPJ Prim Care Respir Med, 2022, 32(1):24.
[40]
Beijers R, Steiner MC, Schols A. The role of diet and nutrition in the management of COPD[J]. Eur Respir Rev, 2023,32(168):230003.
[41]
Capurso C. Increasing our understanding of how dietary components can affect cellular mechanisms that regulate aging and slow the onset of frailty and chronic diseases[J]. Nutrients, 2023,15(12):2687.
[42]
Carbone JW, Pasiakos SM. Dietary protein and muscle mass:Translating science to application and health benefit[J]. Nutrients,2019, 11(5):1136.
[43]
Li M, Zhao L, Hu C, et al. Improvement of lung function by micronutrient supplementation in patients with COPD:A systematic review and meta-analysis[J]. Nutrients, 2024,16(7):1028.
[44]
Hornikx M, Van Remoortel H, Lehouck A, et al. Vitamin D supplementation during rehabilitation in COPD: A secondary analysis of a randomized trial[J]. Respir Res, 2012, 13(1):84.
[45]
Zhang P, Zhong J, Liu X, et al. The association between dynamic changes in vitamin D and frailty alterations: A prospective analysis of UK Biobank participants[J]. J Cachexia Sarcopenia Muscle,2024, 15(5):1722-1732.
[46]
Dent E, Morley JE, Cruz-Jentoft AJ, et al. Physical frailty: ICFSR international clinical practice guidelines for identification and management[J]. J Nutr Health Aging, 2019, 23(9):771-787.
[47]
Cheng X, Hu Y, Ruan Z, et al. Association between B-vitamins intake and frailty among patients with chronic obstructive pulmonary disease[J]. Aging Clin Exp Res, 2023, 35(4):793-801.
[48]
Liang M, Ren X, Zhang Q, et al. The association between dietary magnesium intake and frailty in patients with chronic obstructive pulmonary disease: National Health and Nutrition Examination Survey[J]. Int J Chron Obstruct Pulmon Dis, 2024, 19:2651-2660.
[49]
Wang Z, Hu X, Dai Q. Is it possible to reverse frailty in patients with chronic obstructive pulmonary disease?[J]. Clinics (Sao Paulo), 2020, 75:e1778.
[50]
Maddocks M, Kon SS, Canavan JL, et al. Physical frailty and pulmonary rehabilitation in COPD: A prospective cohort study[J].Thorax, 2016, 71(11):988-995.
[51]
Finamore P, Scarlata S, Delussu AS, et al. Frailty impact during and after pulmonary rehabilitation[J]. COPD, 2021, 18(5):518-524.
[52]
Brighton LJ, Bristowe K, Bayly J, et al. Experiences of pulmonary rehabilitation in people living with chronic obstructive pulmonary disease and frailty. A qualitative interview study[J]. Ann Am Thorac Soc, 2020, 17(10):1213-1221.
[53]
Rolfson DB, Majumdar SR, Tsuyuki RT, et al. Validity and reliability of the Edmonton frail scale[J]. Age Ageing, 2006,35(5):526-529.
[54]
李永春, 丛瑞华, 邱碧秀, 等. 心理行为干预对慢性阻塞性肺疾病患者生命质量影响的研究[J]. 中国实用医药,2015,10(4):223-224.
[55]
Volpato E, Farver-Vestergaard I, Brighton LJ, et al.Nonpharmacological management of psychological distress in people with COPD[J]. Eur Respir Rev, 2023, 32(167):220170.
[56]
Rahi MS, Thilagar B, Balaji S, et al. The impact of anxiety and depression in chronic obstructive pulmonary disease[J]. Adv Respir Med, 2023, 91(2):123-134.
[1] 韩冰, 毕宇彤, 何达. 衰弱指数与腰椎术后并发症关系的荟萃分析[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(03): 233-240.
[2] 余静雅, 石玉兰, 向利娟, 陈城, 罗钰堞. 老年慢性创面患者衰弱现状及影响因素分析[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(02): 141-147.
[3] 潘霞, 李琳, 朱磊, 代超, 庞乐. 汉中社区老年人口腔衰弱风险关联性分析与列线图模型构建[J/OL]. 中华口腔医学研究杂志(电子版), 2025, 19(01): 25-32.
[4] 应允丽, 赵凤德, 韩明锋, 李明, 申辉. 肺腺癌患者衰弱状态与预后关系分析[J/OL]. 中华肺部疾病杂志(电子版), 2025, 18(01): 131-134.
[5] 孔令梅, 徐晓媛, 马丽颖. 慢性阻塞性肺疾病认知衰弱危险因素及预后分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(03): 407-410.
[6] 朱强, 喻航, 郭明学, 徐轶, 朱明辉, 遆新宇, 李王平, 徐浩, 黄勇, 吴海洪, 周云芝, 顾晔, 梁志欣, 杨震, 陈良安. 支气管镜下单向活瓣肺减容术疗效分析:多中心回顾性研究[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(06): 352-359.
[7] 昌淑婷, 陈明明, 许云鹏, 韩雪, 陈秋雨, 刘健. 血清电解质水平与慢性阻塞性肺疾病急性加重患者一年内再入院的相关性[J/OL]. 中华临床医师杂志(电子版), 2025, 19(02): 117-128.
[8] 贾玲玲, 滕飞, 常键, 黄福, 刘剑萍. 心肺康复在各种疾病中应用的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 859-862.
[9] 闫维, 张二明, 张克, 安欣华, 向平超. 北京市石景山区40岁及以上居民早期慢性阻塞性肺疾病异质性及影响因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 533-540.
[10] 张克, 张二明, 闫维, 马石头, 安欣华, 包曹歆, 向平超. 北京石景山区40岁以上PRISm和COPD患者的肺功能水平与吸烟情况相关性分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(02): 122-127.
[11] 曹婧然, 董福强, 张立剑, 刘长乐, 张煜坤, 陈康寅. 老年冠心病患者的营养风险、肌少症和衰弱筛查分析[J/OL]. 中华老年病研究电子杂志, 2024, 11(02): 5-9.
[12] 陈滢双, 石高羽, 王杭悦, 杨杨, 瞿先国. 社会支持在老年人抑郁与衰弱间的中介作用[J/OL]. 中华老年病研究电子杂志, 2024, 11(01): 18-23.
[13] 吴立, 蒋婧瑾. 炎症标志物与老年衰弱综合征[J/OL]. 中华老年病研究电子杂志, 2024, 11(01): 5-10.
[14] 何秀, 敖的, 杨郑, 林小华. 改良呼吸支持策略对慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭患者的疗效[J/OL]. 中华卫生应急电子杂志, 2024, 10(03): 140-144.
[15] 沈洁, 谢鸿阳, 夏翠俏, 黄勇华. 脑小血管病与认知衰弱的研究现状[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(02): 181-184.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?