上胃肠道功能和动力障碍性疾病患者的生活质量评价

Assessing the Quality of Life in Patients with Functional Gastrointestinal Disorders and Diseases of Gastrointestinal Motility

背景:功能性胃肠病(FGIDs)和胃肠动力障碍性疾病(DGIMs)严重影响患者的生活质量。研究患者的健康相关生活质量(HRQL)对深入理解FGIDs和DGIMs的特点以及评价疗效具有重要意义。目的:评估不同上胃肠道FGIDs和DGIMs患者的生活质量,揭示我国FGIDs和DGIMs患者的生活质量状况和意义。方法:以汉化版简明健康调查量表(SF-36)对140名健康对照者以及135例功能性消化不良(FD)患者、50例非糜烂性反流病(NERD)患者和100例反流性食管炎(RE)患者进行生活质量调查,得到生活质量8个维度的评分和2个综合评分[躯体生理健康总评(PCS)和精神心理健康总评(MCS)]并进行分析比较。结果:FD、NERD和RE组的所有8个维度和2个综合评分均显著低于健康对照组(P<0.05)。其中,FD组生活质量最低,MCS评分下降最为突出。除躯体疼痛外,FD组其他7个维度和2个综合评分均显著低于RE组(P<0.05)。与NERD组相比,FD组的社会功能、情感职能、精神健康维度和MCS评分显著降低(P<0.05)。NERD组的生活质量较RE组下降更明显,总体健康、活力维度和PCS评分显著低于RE组(P<0.05)。结论:FGIDs和DGIMs患者的生活质量明显下降,躯体生理健康和精神心理健康均明显受损。FGIDs患者的生活质量较DGIMs患者更低,尤其是在精神心理健康方面。诊治FGIDs和DGIMs时应重视患者生活质量的评价和改善。

Background： The functional gastrointestinal disorders （FGIDs） and diseases of gastrointestinal motility （DGIMs） have an negative impact on quality of life （QOL）. It is important to study the health-related quality of life （HRQL） for better understanding FGIDs and DGIMs and to evaluate their therapeutic effect. Aims： To assess the QOL in patients with FGIDs and DGIMs and to reveal the status and significance of QOL in patients with FGIDs and DGIMs in China. Methods： 140 healthy controls and 285 out-patients including 135 functional dyspepsia （FD）, 50 non-erosive esophageal reflux disease （NERD） and 100 reflux esophagitis （RE） patients were investigated by a Chinese version of the MOS 36-item short form health survey （SF-36）. All the scales were compared and analyzed in 8 dimensions and 2 component-summaries （PCS, MCS）. Results： All 8 dimensions and 2 component-summaries were significantly lower in FD, NERD and RE groups than those in the healthy controls （P〈0.05）. The QOL of FD group is the lowest among the three groups, especially the MCS. Except the dimension of ＂body pain＂, all other dimensions and component-summaries in FD group were significantly lower than those in RE group （P〈0.05）. Compared with NERD group, the social functioning, role limitations due to emotional problems, mental health and MCS in FD group were also significantly lower （P〈0.05）. The decrement of QOL was lower in NERD group than that in RE group （P〈0.05）. The general health, vitality dimension and PCS in NERD group were significantly lower in RE group （P〈0.05）. Conclusions： QOL decreased markedly in patients with FGIDs and DGIMs, in both physical and mental aspects. The decrement of QOL was more prominent in patients with FGIDs than that in patients with DGIMs, in particular the mental aspect. Emphasis should be placed on assessing and improving QOL while treating patients with FGIDs and DGIMs.