SF-36量表在MDR-TB患者生命质量评估中的应用

Assessment on quality of life in MDR-TB patients using SF-36 scales

目的评价SF-36量表在耐多药肺结核(MDR-TB,同时耐利福平和异烟肼)患者中的适用性,并分析相关因素对生存质量的影响。方法用SF-36量表对100例MDR-TB患者和200名健康志愿者进行生命质量测评,评价量表的信度和效度。对完成疗程100例患者治疗前、治疗3个月及治疗1年的生命质量总评分及各维度得分进行配对t检验、多元方差分析评价疗效。对生命质量的影响因素进行单因素分析和多因素逐步回归分析。结果 SF-36量表分半信度0.96,各维度及总表的Cronbach’sа系数均大于0.7。MDR-TB患者的生命质量总分及8个维度得分与正常对照组相比差异有统计学意义(P<0.05);治疗3个月或治疗1年的生命质量总分及8个维度的得分明显高于治疗前且差异有统计学意义(P<0.05);治疗1年后的总分及PF、PR、GH、VT、SF、ER、MH7个维度较对照组低并差异有统计学意义(P<0.05)。影响MDR-TB患者生命质量的主要因素是:文化程度、耐药数目、不规则治疗、Hb降低。结论 SF-36量表适于在MDR-TB患者中运用.MDR-TB患者的生命质量均显著降低,治疗后生命质量明显提高,但治疗1年后仍不能恢复正常。影响MDR-TB患者生命质量的主要因素是:文化程度、耐药数目、不规则治疗、Hb降低。

Objective To evaluate the applicability of the SF-36 scales in measuring the quality of life of patients with multi-drug resistant pulmonary tuberculosis（MDR-TB）,to analyze the factors affecting the quality of patient＇s life. Methods SF-36 instrument was used to measure and evaluate the quality of life of 100 MDR-TB patients and 200 healthy people.The reliability and validity of SF-36 were evaluated.Overall value and value of each domain before treatment,3 month and 1 year after treatment start were measured for 100 patients.Treatment effect was evaluated by paired t test and analysis of variance.Simple and multiple stepwise regression analysis were made to evaluate factors affecting the quality of life. Results The split-half reliability of scales was 0.96,Overall Cronbach＇s а coefficients and coefficients in each domain were all larger than 0.7.There were significant differences for the overall scores of quality of life and scores in eight domains between the MDR-TB patients and the normal people（P0.05）;overall scores of quality of life and eight domains in 3 months or 1 year after treatment start were significantly higher than before treatment（P0.05）.After patient completed 1 year treatment,the scores of overall quality of life and in PF、PR、GH、VT、SF、ER、MH＇s domains were lower than control groups（P0.05）.The main factors affecting the quality of life of MDR-TB patients were cultural level,kinds of drug resistant,irregular treatment and reduction of white blood cell counts. Conclusion The SF-36 scales is applicable for measuring the quality of life of MDR-TB patients.The quality of life of MDR-TB patients decreased greatly,and increased significantly after treatment,but still could not recover to normal after 1 year therapy.The main factors affecting the quality of life of MDR-TB patients were cultural level,kinds of drug resistant,irregular treatment and reduction of white blood cell counts.