目的  对我国老年(年龄≥60岁)维持性血液透析(maintenance hemodialysis,MHD)患者衰弱患病率及影响因素进行Meta分析,为早期诊断和干预提供参考。 方法 系统检索Embase、Cochrane Library、PubMed、WOS、CINAHL、SinoMed、中国知网、维普和万方数据库,检索时间从建库至2024年4月,Meta分析使用Stata 15.0软件。 结果 共纳入11篇文献,2007例老年MHD患者,发生衰弱患者1008例,共涉及28项影响因素。Meta分析发现我国老年MHD患者衰弱患病率为48%(95% CI：37.2%～58.9%)。年龄(OR=1.163,95% CI：1.066～1.269,P=0.001)、女性(OR=2.143,95% CI：1.296～3.543,P=0.003)、C反应蛋白(OR=1.331,95% CI：1.124～1.576,P=0.001)、抑郁(OR=4.231,95% CI：1.524～11.751,P=0.006)、合并糖尿病(OR=3.242,95% CI：1.943～5.410,P＜0.001)、合并心血管疾病(OR=4.066,95% CI：2.225～7.430,P＜0.001)为我国老年MHD患者衰弱的危险因素；日常生活能力(OR=0.886,95% CI：0.791～0.993,P=0.037)为我国老年MHD患者衰弱的保护因素。 结论 我国老年MHD患者衰弱患病率处于较高水平,临床医护人员应重视老年MHD患者,依据影响因素识别衰弱并采取个性化的干预措施,做到早筛查、早预防、早治疗。

Objective To explore the prevalence of frailty and its influencing factors among elderly maintenance hemodialysis (MHD) patients in China by a meta-analysis, and to provide references for early diagnosis and intervention of the frailty.  Methods  We systematically searched for the databases of Embase, Cochrane Library, PubMed, WOS, CINAHL, SinoMed, CNKI, VIP and WanFang. The search period was from the establishment of the database to April 2024. Meta-analysis was performed using the Stata 15.0 software.  Results  A total of 11 literatures were obtained, containing 1008 patients with frailty in the 2007 elderly MHD patients, and 28 related influencing factors. Meta-analysis found that the prevalence of frailty in elderly MHD patients in China was 48% (95% CI: 37.2%～58.9%). Age (OR=1.163, 95% CI: 1.066～1.269, P=0.001), female (OR=2.143, 95% CI: 1.296～3.543, P=0.003), C-reactive protein (OR=1.331, 95% CI: 1.124～1.576, P=0.001), depression (OR=4.231, 95% CI: 1.524～11.751, P=0.006), complicated with diabetes (OR=3.242, 95% CI: 1.943～5.410, P＜0.001) and complicated with cardiovascular disease (OR=4.066, 95% CI: 2.225～7.430, P＜0.001) were the risk factors for frailty in elderly MHD patients in China. Ability of daily living (OR=0.886, 95% CI: 0.791～0.993, P=0.037) was a protective factor for frailty in elderly MHD patients in China.  Conclusion  The prevalence of frailty in Chinese elderly MHD patients is at a higher level. Clinical staff should pay attention to elderly MHD patients, identify the influence factors for frailty, and take individualized intervention measures, so as to achieve early recognition, prevention, treatment and a higher survival rate.