常见慢性病对农村中老年人群生命质量的影响研究

Impact of Common Chronic Disease on Health Related Quality of Life in Middle-aged and Elder Residents of the Rural Community

目的了解目前农村中老年人群原发性高血压、糖尿病、冠心病和脑卒中的患病状况,评价其对生命质量的影响。方法本次横断面研究共纳入5 345例研究对象,应用欧洲五维度健康量表(EQ-5D)描述研究对象生命质量情况,通过问卷调查和体格检查收集常见慢性病患病情况、健康相关行为情况、健康自我评价以及血压、身高、体质量等信息。应用因子回归评价健康相关生命质量的影响因素,采用非条件Logistic回归分析,以非患者为对照,分别计算四种慢性病调整年龄后发生健康状态不良的相对危险度(OR)及其95%置信区间(95%CI),分析患病种类对人群健康生命质量的影响。结果研究对象EQ-5D健康指数平均为(0.923±0.145)。患有慢性病的对象占73.1%,慢性病患者EQ-5D健康指数(0.907±0.155)低于不患慢性病的对象(0.963±0.105),差异有统计学意义(t=15.082,P<0.01)。与对照组相比,慢性病患者发生健康状态不良的风险由大到小依次为脑卒中1.46[95%CI(1.15,1.85)]、糖尿病1.27[95%CI(1.05,1.53)]、高血压1.25[95%CI(1.06,1.47)]和冠心病1.12[95%CI(0.96,1.32)]。男性脑卒中患者[OR=1.90,95%CI(1.32,2.73)]、女性糖尿病患者[OR=1.30,95%CI(1.04,1.63)]更容易发生健康状态不良。结论农村社区中老年慢性病患者生命质量较低,常见慢性病中脑卒中对生命质量的影响最大。加强慢性病防治是改善农村中老年人群生命质量的重要途径。

Objective To investigate the prevalence of essential hypertension,diabetes,coronary heart disease（CHD） and stroke among middle-aged and elder residents of the rural community and to evaluate the impact of the diseases on health related quality of life（HRQoL）.Methods Data of 5 345 individuals were obtained.Questionnaire was applied to collect the information of general health-related behaviors,chronic conditions,self-rated health,blood pressure,height,and body weight.HRQoL was measured with the EuroQol questionnaire（EQ-5D）.Factorial analysis using varimax rotation was used to identify the influence factors on HRQoL.Odds ratios were calculated by nonconditional logistic regression model adjusting for age.Results The average EQ-5Dindex as（0.923±0.145）.Overall,73.1% of the respondents were in chronic conditions.Participants with chronic diseases showed significantly lower EQ-5D index（0.907±0.155） than those without（0.963±0.105）（t=15.082,P0.01）.Significant correlations were found between a lower HRQoL and chronic diseases.The odds ratios and 95% confidence interval（95%CI） of hypertension,diabetes,CHD and stroke were as follow：1.25（1.06 to 1.47）,1.27（1.05 to 1.53）,1.12（0.96 to 1.32）,and 1.46（1.15 to 1.85）.The most influential diseases were stroke in malesand diabetes in females.Conclusion This study suggests that chronic diseases are correlated with low health related quality of life,and stroke is the major influential factor of HRQoL.