老年慢性肺炎患者口腔衰弱纵向轨迹变化及其影响因素 [中文引用][英文引用]

目的 分析老年慢性肺炎患者口腔衰弱的纵向轨迹变化及其影响因素，为临床开展针对性口腔健康管理与干预提供依据。方法 选取 2023 年 2 月— 2025 年 2 月在浙江省某三级甲等综合医院确诊的 220 例老年慢性肺炎患者为研究对象，采用一般资料调查表、口腔衰弱指标筛查 -8（oral frailty index-8，OFI-8）、微营养评定法简表（short-form mini-nutritionalassessment，MNA-SF）、自我调节疲乏量表（self-regulatory fatigue scale，SRFS）、一般疏离感量表（general alienation scale，GAS）分别于患者确诊时（T0）、确诊 3 个月（T1）及 6 个月（T2）进行调查。采用潜在类别增长分析拟合口腔衰弱的纵向轨迹，采用多分类 Logistic 回归分析其影响因素。结果 202 例患者完成研究。老年慢性肺炎患者的口腔衰弱纵向潜在轨迹分为 3 类。口腔衰弱下降组（16.8%）、口腔衰弱上升组（25.3%）、口腔衰弱稳定组（57.9%）。年龄、吸烟、用药种类、自我调节疲乏和社会疏离感是老年慢性肺炎患者口腔衰弱轨迹变化的影响因素（均 P<0.05）。结论 老年慢性肺炎患者的口腔衰弱轨迹具有群体异质性，医护人员需重点关注年龄≥ 80 岁、目前吸烟、用药种类≥ 3 种、自我调节疲乏和社会疏离感程度高的老年慢性肺炎患者，并实施分层、动态的口腔健康管理与干预策略，以延缓或改善口腔衰弱的进展。

Objective To identify the longitudinal trajectories of oral frailty in older adults with chronic pneumonia and to examine its influencing factors, so as to provide a basis for targeted oral health management and clinical interventions. Methods A total of 220 older adults diagnosed with chronic pneumonia were recruited from a Tier-IIIA hospital in Zhejiang, between February 2023 and February 2025. Data were collected using the oral frailty index-8（OFI-8）, the short-form mini nutritional assessment（MNA-SF）, the self-regulatory fatigue scale（SRFS）, and the general alienation scale（GAS）at three time points：diagnosis（T0）, 3 months post-diagnosis （T1）, and 6 months post-diagnosis（T2）. Latent class growth analysis was used to identify the longitudinal trajectory of oral frailty and multivariable logistic regression was used to examine the influencing factors. Results A total of 202 participants completed the study with three emerged patterns：decreasing（16.8%）, increasing（25.3%）, and stable（57.9%）. Age, smoking, medication, self-regulatory fatigue and social alienation were significant factors influencing the trajectories（all P<0.05）. Conclusion Older adults with chronic pneumonia exhibit group heterogeneous trajectories of oral frailty. Clinicians should pay particular attention to those who were 80 or older, smoker, taking ≥ 3 types of medication, with high self-regulatory fatigue, and high levels of self-regulatory fatigue or social alienation. Stratified, dynamic oral health management and intervention strategies should be implemented to delay or ameliorate the progression of oral frailty in this population.