关键词: 结核,肺, 老年人, 日常生活活动, 躯体感觉障碍

Abstract:

Objective: To investigate the physical function and influencing factors of elderly hospitalized pulmonary tuberculosis patients. Methods: A total of 429 elderly pulmonary tuberculosis patients (aged 60-95 years) who were hospitalized in the Tuberculosis Department of Chengdu Public Health Clinical Medical Center from June 2021 to December 2021 as the research subjects were conveniently selected, and information of them were collected, including the age, gender, marital status, residence, education level, smoking history, drinking history, body mass index, drug resistance, treatment classification, and sputum bacterial test results of the research subjects. The Barthel index (BI), Berg balance scale (BBS), and Morse fall assessment scale (MFS) were used to evaluate the physical function of the study subjects. Results: The BI score of the study subjects was 81.97±17.62, the BBS score was 49.82±11.09, and the MFS score was 41.90±12.79. The scores of BBS, BI, and MFS in elderly tuberculosis patients aged over 80 years old were 40.32±14.56, 72.76±17.66, and 51.58±12.63, respectively, while the scores of those aged 60-70 years were 51.80±9.78, 84.92±15.69, and 40.06±12.22, respectively; multiple regression analysis showed that the older the elderly patients with pulmonary tuberculosis, the poorer their ability to perform daily activities (standard regression coefficient: -0.183, t=-3.797, P<0.001), balance and gait abilities (standardized regression coefficient: -0.245, t=-5.220, P<0.001), and the greater the risk of falling (standardized regression coefficient 0.187, t=3.802, P<0.001). The scores of BBS, BI, and MFS in elderly tuberculosis patients with body mass index <18.5 were 45.07±14.03, 75.82±17.82, and 46.12±12.83, respectively, while the scores of those who with body mass index between 24.0 and 28.0 were 53.13±6.86, 89.29±12.44, and 37.46±11.74, respectively; multiple regression analysis showed that elderly tuberculosis patients with lower body mass index had poorer activities of daily living (standardized regression coefficient: 0.146, t=3.086, P=0.002), poorer balance and gait abilities (standardized regression coefficient: 0.133, t=2.806, P=0.005), and higher risk of falling (standardized regression coefficient: -0.119, t=-2.477, P=0.014). The scores of BBS, BI, and MFS in elderly tuberculosis patients with 5-6 comorbidities were 48.18±11.64, 82.27±20.78, and 38.64±15.35, respectively, while the scores in elderly tuberculosis patients with 1-2 comorbidities were 51.55±8.86, 84.76±14.39, and 41.37±12.35, respectively; multiple regression analysis showed that elderly tuberculosis patients with more comorbidities had poorer activities of daily living (standardized regression coefficient: -0.139, t=-2.967, P=0.003), as well as poorer balance and gait abilities (standardized regression coefficient: -0.162, t=-3.494, P=0.001). The BBS score of elderly tuberculosis patients with positive sputum bacteria was 48.75±11.37, significantly lower than that of those with negative sputum bacteria (50.64±10.90, t=1.722, P=0.046). Conclusion: In elderly patients with pulmonary tuberculosis, the older the age, the lower the body mass index, the more comorbidities, and the positive sputum bacteria result in lower physical function. In the diagnosis and treatment process, comprehensive evaluation and early intervention should be combined with the relevant influencing factors of decreased physical function.

Key words: Tuberculosis, pulmonary, Aged, Activities of daily living, Somatosensory disorders