炎症性肠病患者健康相关生活质量评价研究

The evaluation of health-related quality of life in patients with inflammatory bowel disease

目的研究炎症性肠病（IBD）患者的健康相关生活质量（HRQoL）及其影响因素。方法应用中文版IBD问卷（C—IBDQ），对IBD患者进行横断面调查，评价其HRQoL；通过相关分析和多元线性回归分析，筛选出影响IBD患者HRQoL的主要因素。结果100例1BI）患者（UCS0例，CD17例，未分型3例）完成问卷，HRQoL总分为（175．9±37．9）分，各维度评分均有下降，其中情感功能受损最为明显；UC患者与CD患者HRQoL总分差异无统计学意义（P〉0．05）。活动期1BD患者的HRQoL总分及各维度评分均明显低于缓解期患者（158．7±41．4比186．6±35．1；r=2．813，P=0．006）；病程〈1年的患者HRQoL明显低于病程1年以上的患者（P〈0．05）；重型IBD患者的HRQoL明显低于轻型患者（P〈0．05）；医疗费用主要由个人支付的患者HRQoL较费用大部分由医保支付的患者低，两者在社会功能及经济负担维度差异有统计学意义（P〈0．05）。多元线性回归分析提示，对IBD患者HRQoL有影响的因素为病情、疾病活动度、病程、付费方式等。结论IBD患者HRQoL均有不同程度受损；影响IBD患者HRQoL的因素有病情、疾病活动度、病程、付费方式等；经济负担对IBD患者HRQoL有明显影响。

Objective To investigate the health related quality of life （HRQoI.） and its influencing factors in patients with inflammatory bowel disease （IBD）. Methods The IBD patients underwent cross-sectional survey through Chinese version of inflammatory bowel disease questionnaire （C IBDQ）, the HRQoL of IBD patients were evaluated and analyzed with correlation analysis and muhiple-linear regression analysis. Results A total of 100 IBD patients finished the questionnaire （UC80, CD 17, ID3）. The overall scoreof HRQoL in IBD patients were （175.9＋37.9）, score of each item decreased, especially in the aspect of emotional function. There was no significantly difference in total scores of HRQoL between UC patients and DC patients （P〉0.05）. The HRQoL total scores and each item score of patients in active period were significantly lower than those in remission period （149.4±5.2,195. 1±26.7;P〈0. 05）. The HRQoL scores of patients with the duration less than one year were significantly lower than those over one year （P〈0.05）. The HRQoI. scores of severe patients were significantly lower than those of mild patients （P〈0.05）. The HRQoL scores of patients whose medical cost mainly paid by themselves were lower than those paid by medical insurance, there were significant differences in social function and economic burden between these two groups. Multiple linear regressions analysis indicated that the influential factors of HRQoL were disease severity and activity, duration, and the payment. Conclusions The HRQoL of IBD patients are impaired in varying degrees. The influential factors of HRQoI. were disease severity and activity, duration, and the payment. The HRQoL of IBD patients is obviously affected by economic burden.