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目的:调查上海市社区卫生服务中心长期住院老年患者铁代谢状态，探索其危险因素，为进一步干预提供依据。方法:于2018年10月7日至11月7日整群随机抽取上海市奉贤区4家社区卫生服务中心，采集所有226例连续住院时间≥30 d且年龄≥65岁的老年患者的基本信息，进行身体测量和基础性日常生活活动能力（Katz指数）、智力（简易精神状态检查表）、营养状态（微型营养评定法简表）评估，检测血清铁蛋白等血液指标。依据血清铁蛋白水平将患者分为铁缺乏、铁正常、铁超载3组，并对影响铁超载的因素进行单因素和多因素分析。结果:226例患者年龄（84.2±8.1）岁，男性占37.2%（84/226），连续住院天数160（81，409） d。其中，铁缺乏、铁正常和铁超载者分别占1.8%（4/226）、34.9%（79/226）和 63.3%（143/226），3组患者血清铁蛋白值分别为（14.6±9.4）、（97.3±46.7）和（324.8±188.9）μg/L。单因素分析发现，与铁正常者相比，铁超载者的腰围［（84.3±11.9）比（88.3±11.8）cm，n t=2.390，n P=0.018］、小腿围［（28.2±5.0）比（29.8±5.7）cm，n t=2.192，n P=0.029］较小， 微型营养评定法简表得分分类差异有统计学意义（n χ2=7.458，n P=0.024）。校正年龄、性别后，多因素logistic回归分析提示，微型营养评定法简表得分处于营养不良风险的患者发生铁超载的风险是营养正常患者的2.169倍（95%n CI：1.108~4.247，n P=0.024）。n 结论:在社区卫生服务中心长期住院老年人中铁超载极为常见，基层全科医生应仔细评估此类人群的铁代谢状态，尤其是有营养不良风险的对象。“,”Objective:To investigate the iron status of the long-term hospitalized elderly patients in community health centers and explore its risk factors of iron overload.Methods:Four community health centers were selected for study by cluster random method from Fengxian District of Shanghai from October 7, 2018 to November 7, 2018. The data of 226 patients ≥65 years who had been long-term hospitalized (≥30 consecutive days) were collected, including the basic information, physical measurement, basic activities of daily living (Katz index), cognitive disorder (mini-mental state examination), nutritional status (mini nutritional assessment-short form), and serum ferritin. According to serum ferritin levels, patients were divided into three groups: iron deficiency, normal iron and iron overload, and the risk factors for iron deficiency were tested by univariate and multivariate regression analysis.Results:The mean age of 226 patients was (84.2±8.1) years, and males accounted for 37.2% (84/226), with average 160 (81, 409) consecutive days of hospitalization. The proportion of patients with iron deficiency, normal iron and iron overload were 1.8% (4/226), 34.9% (79/226) and 63.3% (143/226). The mean values of corresponding serum ferritin were (14.6±9.4) ng/ml, (97.3±46.7) ng/ml and (324.8±188.9) μg/L, respectively. Univariate analysis showed that compared with the patients with normal iron status, waist circumference [(84.3±11.9) cm n vs.(88.3±11.8) cm, n t=2.390, n P=0.018] and calf circumference [(28.2±5.0)cm n vs. (29.8±5.7) cm, n t=2.192, n P=0.029] of the patients with iron overload were smaller, and there were significant differences in scores of the Short-Form Mini-Nutritional Assessment between two groups (χn 2=7.458, n P=0.024). After adjusting for age and gender, multivariate logistic regression analysis indicated that the risk of iron overload for patients with malnutrition was 2.169 times (95%n CI: 1.108-4.247, n P=0.024) higher compared with those in normal nutrition status.n Conclusion:Iron overload is common in elderly patients who are long-term hospitalized in community health centers; general practitioners should carefully assess the iron status for them, especially for those with malnutrition.