牡丹江医科大学学报

目的 探讨睡眠质量在老年社区获得性肺炎患者久坐行为与衰弱间的中介效应。方法 便利选取2024年1月至2025年6月莆田市仙游县总医院收治的234例老年CAP患者为研究对象，采用一般资料调查表、久坐行为测量问卷、匹兹堡睡眠质量指数量表、格列宁根衰弱指标量表对患者进行问卷调查。采用Pearson相关性分析分析患者久坐行为、睡眠质量、衰弱间的相关性。以线性回归方程分析衰弱的影响因素。构建结构方程模型分析睡眠质量在久坐行为与衰弱间的中介效应。结果 234例老年CAP患者共回收有效问卷226例，有效回收率为96.58%。226例老年CAP患者久坐时间(7.04±1.34)h/d，睡眠质量得分为(12.46±1.32)分，衰弱得分为(6.39±0.87)分。Pearson相关性分析结果显示，久坐行为、睡眠质量得分与衰弱得分呈正相关，久坐行为与睡眠质量得分呈正相关(均P<0.05)。单因素分析示，不同年龄、合并糖尿病、疾病严重程度的患者衰弱得分差异有统计学意义(均P<0.05)。线性回归方程结果显示，年龄、合并糖尿病、疾病严重程度、久坐行为、睡眠质量得分均为衰弱得分的影响因素(均P<0.05)。结构方程模型结果显示，久坐行为可直接正向影响衰弱，还可通过睡眠质量的中介效应间接影响衰弱，中介效应占总效应的35.49%(均P<0.05)。结论 老年CAP患者衰弱处于中等水平，睡眠质量在患者久坐行为与衰弱间存在中介效应，临床或可通过减少久坐行为，改善患者睡眠质量以缓解衰弱。

Objective To explore the mediating effect of sleep quality on sedentary behavior and frailty in elderly patients with community-acquired pneumonia(CAP). Methods A total of 234 elderly CAP patients admitted to the hospital from January 2024 to June 2025 were conveniently selected as the study subjects. General demographic questionnaires,sedentary behavior measurement questionnaires,Pittsburgh Sleep Quality Index,and Groningen Frailty Indicator were used to conduct surveys among the patients. Pearson correlation analysis was used to analyze the correlation between sedentary behavior,sleep quality,and frailty. Univariate analysis and linear regression equation analysis were used to analyze the influencing factors of frailty. A structural equation model was constructed to analyze the mediating effect of sleep quality on sedentary behavior and frailty. Results A total of 226 valid questionnaires were recovered from the 234 elderly CAP patients,with an effective response rate of 96.58%. The average daily sedentary time of the 226 patients was(7.04±1.34) hours,the sleep quality score was(12.46±1.32) points,and the frailty score was(6.39±0.87) points. Pearson correlation analysis showed that sedentary behavior and sleep quality score were positively correlated with frailty score,and sedentary behavior was positively correlated with sleep quality score(all P< 0.05). Univariate analysis indicated that there were statistically significant differences in frailty scores among patients with different ages,with or without diabetes mellitus,and with different disease severities(all P < 0. 05). Linear regression analysis revealed that age,comorbid diabetes,disease severity,sedentary behavior and sleep quality score were all influencing factors of frailty score(all P<0.05). The results of SEM showed that sedentary behavior could directly and positively affect frailty,and also indirectly influence frailty through the mediating effect of sleep quality,which accounted for 35.49% of the total effect(all P<0.05). Conclusion Frailty in elderly CAP patients is at a moderate level,and sleep quality has a mediating effect between patients' sedentary behavior and frailty.Clinically,improving patients' sleep quality and reducing sedentary behavior may alleviate frailty.