风湿性心脏病二尖瓣狭窄患者健康相关生存质量的研究

Health-related quality of life in patients with mitral stenosis of rheumatic heart disease

目的 探讨与评价风湿性心脏病二尖瓣狭窄 (MS)患者的健康相关生存质量 (HRQOL ) ,为全面评 MS球囊成形术 (PTMV )治疗效果提供相应的依据。方法 应用 SF- 36生存质量表对 90例 MS患者及 90名健康者同期横断面调查与对比 ,并用受试者特征曲线 (ROC)确定 HRQOL最佳诊断参考值。然后对治疗组采用自身前后对照设计 ,经 PTMV治疗三个月后 ,分析比较了 HRQOL与治疗效果之间的关系。结果 (1) MS患者有关生理、心理、社会功能的 8项指标均较对照组减少(P <0 .0 5～ 0 .0 1) ;本研究的 HRQOL正常判断参考值为 2 90分 ,其敏感性 82 % ,特异性 74%。结论 MS患者的健康相关生存质量显著低于正常人 ;HRQOL测试有利于对 MS患者治疗效果的综合评价。

Objective To explore the health related quality of life(HRQOL)for patients with mitral stenosis of rheumatic heart disease(MS) and to provide reasonabal evidence for evaluating the effectiveness of percutaneous mitral balloon valvotomy(PTMV) therapy in clinical practice Methods A cross sectional study was usde to survey 90 patients with MS and 90 health people using SF 36 short form of quality oflife in community The cutoff point score of HRQOL was decided by receiver oprating characteristic(ROC) Curve analysis Before and after the the treatemmet with PTMV,their HRQOL was measured and evaluated,and the relationship between the change of HRQOL and PTMV effect was evaluated Results 8 domains were significantly lower in patient′s grouq than in the control group,which included social function、role limitations attributed to both physical and emotional problems、mental health、activity or fatigue and overall evaluation of healthe(P<0 05~0 01) A cutoff point of HRQOL was decided using ROC analysis which the 290 score was the best one for diognostic HRQOL with the sensitivity of 82% and a specificity of 74% Comclusion The HRQOL of these MS patients was significantly lower than that in the health people in the study The measurement of HRQOL was more useful to evaluate the PTMV effectiveness in clinical practice