老年炎症性肠病患者的生存质量及其影响因素

Study on the quality of life of patients and its influencing factors of elderly inflammatory enteropathy

目的了解老年炎症性肠病(IBD)患者的生存质量(QOL)及影响因素。方法采用问卷调查法,对消化内科门诊及病房收治的老年患者100例进行一般资料及生存质量的横断面调查,应用中文IBgQ、SF-36、焦虑自评量表、抑郁自评量表、简易应对方式问卷、社会支持评定量表,通过相关分析和多元回归分析,筛选出影响IBD患者QOL的主要因素。结果 100例老年IBD患者中溃疡性结肠炎(UC)者72例,克罗恩病(CD)者28例,其中两组参与研究入选者相比,人口学特征无显著差异;所有IBD患者的IBDQ总评分为148.85±26.31,肠道症状得分为48.85±8.69,全身症状得分为20.96±5.43,情感功能得分为54.46±10.29,社会功能得分为21.78±5.97,所有维度得分均处于中等水平;UC患者与CD患者在各维度得分均比较接近,且都处于中等水平,两组患者的QOL之间无明显差异(P>0.05);老年IBD患者与健康对照组QOL比较,结果显示各维度得分均低于健康对照组(P<0.05);不同文化程度、职业的IBD患者QOL的差别有统计学意义(P<0.05)。高学历患者SF-36的心理、社会领域的评分明显低于低学历患者(P<0.05);重型IBD患者在IBDQ和SF-36总分及其他各维度得分均低于轻型患者(P<0.05);积极应对、社会支持等得分与QOL得分呈正相关(P<0.05);焦虑、抑郁、消极应对得分与生存质量得分呈负相关(P<0.05)。多元回归分析显示,抑郁、焦虑、病情、文化程度、病期是影响IBD患者生存质量的相关因素。结论病情重的IBD患者的生存质量较低;焦虑、抑郁水平越高,患者的生存质量越低。IBD患者主要在心理健康方面受到影响。

Objective To understand the inflammatory bowel disease ( IBD ) patients ’ quality of life ( QOL ) influencing fac-tors.Methods Questionnaire was used to collect 100 patients ’ data including general information and living quality of the cross-sectional survey by application Chinese IBgQ , SF-36, self rating anxiety scale , self rating depression scale , simple coping style questionnaire , social support rating scale.Correlation analysis and multiple regression analysis were used to screen out the main factors affecting the IBD of pa -tients with QOL.Results There were 72 cases of UC and 28 cases of CD in 100 IBD patients and there was no significant differences in the demographic between the two groups.Total IBDQ score was 148.85 ±26.31 , intestinal tract symptoms score 48.85 ±8.69 , systemic symp-tom score 20.96 ±5.43 , emotion functional score 54.46 ±10.29 , social function score 21.78 ±5.97 of all IBD patients , and all scores were in the medium level.UC patients and CD patients were relatively close to the score of each dimension , and were in the medium level , there were no significant differences in quality of survival between two groups of patients.Elderly IBD patients ’ scores were lower than those of the healthy controls ( P<0.05 ).There were significant differences among different culture degree and occupation IBD patients .Scores of high degree patients in psychological , social domain score of SF-36 were significantly lower than those of low degree ( P<0.05 ).IBDQ and SF-36 scores of patients with severe IBD were lower than those of light IBD patients ( P<0.05 ).Positive coping , social support score and quality of life scores were positively correlated (P<0.05).Anxiety, depression, negative coping style and quality of life scores were nega-tively correlated (P<0.05).Multiple regression analysis showed that depression , anxiety, illness, disease stage, culture degree were the re-lated factors influencing the life quality of patients with IBD.Conclusions The severity of life quality of IBD patients is low , the higher the level of anxiety and depression , the lower quality of life.IBD patients mainly are affected in terms of mental health .