影响成年癫痫患者生活质量的危险因素分析

Factors Affecting the Quality of Life in Audlt Patients with Epilepsy

目的调查影响成年癫痫患者生活质量的因素。方法采用癫痫患者生活质量量表-31中文版(QOLIE-31中文版),对148例成年癫痫患者的生活质量进行评估。采用单因素分析对可能与癫痫患者生活质量有关的人口学变量(性别、年龄、婚姻状况、职业、教育程度等)、临床变量(起病年龄、病程、发作类型、发作频率、药物治疗等)及精神共病(抑郁、焦虑)进行筛选,再用多元逐步回归分析可能的预测因素。结果影响癫痫患者生活质量的因素,包括职业(P<0.05)、教育程度(P<0.05)、发作频率(P<0.05)、抑郁(P<0.001)及焦虑(P<0.001)。在多元回归分析中,抑郁(P<0.001)是解释癫痫患者低生活质量最强的因素,焦虑(P<0.001)也是预测因素。结论抑郁及焦虑超过了人口学及临床变量对癫痫患者生活质量的影响。识别和处理精神共病可以提高癫痫患者的生活质量。

Objective To investigate the factors affecting the quality of life in audlt patients with epilepsy.Methods We used QOLIE-31 Chinese version to evaluate the quality of life in 148 epilepsy patients.Univariate analysis were performed to explore the association among QOL in patients with epilepsy,possible prognostic demographic variables（gender,age,marital status,profession,education,etc.）,clinical variables（age of onset,duration,type of seizures,seizure frequency,medication,etc.） and psychiatric comorbidity（depression,anxiety）.Using multiple regression analysis,we determined which variables were associated with QOLIE-31 overall and subscale scores.Results Factors affecting the QOL in epilepsy patients were profession（P〈0.05）,education（P〈0.05）,seizure frequency（P〈0.05）,BDI score（P〈0.001） and BAI score（P〈0.001）.In multiple regression analysis,the symptom of depression（P〈0.001） was the most important factor in explaining the lower QOL in patients with epilepsy,while the symptom of anxiety（P〈0.001） was also a significant factor.Conclusion Depression and anxiety outweighed the demographic and clinical factors in determining the QOL in adult epilepsy patients.Finding and treatment of the psychiatric comorbidity could improve the QOL in these patients.