WHO-BREF量表用于系统性红斑狼疮患者生活质量的评价及影响因素分析

Application of WHO-BREF to evaluating quality of life of patients with systemic lupus erythematosus (SLE)

目的:评价我国系统性红斑狼疮患者的生活质量并探讨其影响因素。方法:用系统性红斑狼疮疾病活动指数计分(SLEDAI)和系统性红斑狼疮国际合作临床的系统性红斑狼疮损伤指数计分(SLICCACRDI)分别测定153例系统性红斑狼疮患者的活动指数和损伤指数,用世界卫生组织生活质量简表(WHOQOL鄄BREF)中文版对患者的生活质量进行自评。将患者按照临床诊断类型和临床分期进行分组,对不同分型和分期患者各个领域的生活质量得分进行方差分析,并对各领域得分与可能的影响因素进行相关分析和多元逐步回归分析。结果:SLE患者生活质量得分普遍较低,各领域得分从46.49±20.05到64.52±15.33不等。影响生活质量的主要因素有疾病的临床分期、活动指数、损伤指数、年龄、文化程度、家庭关系等。其中受疾病本身影响较明显的生活质量领域有生理、心理、总体健康感觉和量表总得分。结论:SLE患者生活质量较差,临床分期、活动度、损伤程度影响患者的生理功能和总体健康感觉;生理、心理、社会关系、环境领域的生活质量还受年龄、文化程度、家庭关系的影响。

Objective: To evaluate the quality of life of patients with systemic lupus erythematosus (SLE) and to explore its main influential factors. Methods: The clinical characters of one hundred and fifty-three patients with SLE were investigated and their quality of life was assessed. QOL was evaluated using the brief scale of quality of life of WHO (WHOQOL-BREF), which consists of five subscales including 26 items. SLE disease activity index score (SLEDAI score) and Systemic Lupus International Collaborating Clinic/American College of Rheumatology Damage Index (SLICC/ACR DI) were used to measure disease activity and cumulative damage respectively. The statistical methods used included ANOVA, Spearman correlation and multiple linear regressions. Results: The scores of WHOQOL-BREF subscales varied from 46.49±20.05 to 64.52±15.33, which were relatively low. The main factors influencing QOL included age, culture, clinical stage, SLEDAI, SLICC/ACR DI and conflicts with family members. Conclusion: The quality of life of patients with SLE is fairly poor. The physical function and general health feeling are influenced by clinical stage, disease activity and damage. All fields of quality of life are associated with age, culture and relationship with family members.