多发性骨髓瘤患者的生活质量及相关因素研究

Study on the quality of life and its related factors on patients with multiple myeloma

目的评估多发性骨髓瘤（MM）患者的生活质量，探讨相关影响因素。方法收集2010年8月至2013年3月在西安市5家三级甲等医院血液科住院的227例MM患者临床和实验室资料。采用欧洲癌症研究与治疗组织开发的生活质量测定量表（QLQ-C303．0）中文版进行生活质量的评估，以该量表的常模作为对照，利用SPSS 17．0软件进行统计学分析。结果MM患者总体生活质量评分（49．0±21．7）低于常模（60．7±23．4），乏力、恶心呕吐、疼痛、呼吸困难、睡眠障碍、食欲下降、便秘、经济困难等症状得分高于常模，差异有统计学意义（P〈O．05）。老年人（尤其是年龄／〉70岁患者）、费用自付比例较高的农村居民、经济困难是影响生活质量的主要因素（P〈0．05）；患者生活质量随着ISS分期的增高而下降（P〈0．05）；血红蛋白降低、血清钙和球蛋白增高对MM患者生活质量有负面影响（P〈O．05）。结论MM患者总体生活质量明显下降，且低于其他肿瘤患者的生活质量。乏力、疼痛和经济困难等是影响患者生活质量的主要因素；治疗效果评估应更加关注血红蛋白、血清钙和球蛋白的改善情况。

Objective To evaluate the quality of life and influencing factors on patients with multiple myeloma （MM）. Methods 227 MM cases were selected at 5 hospitals in Xi＇ an from August, 2010 to March, 2013. QLQ-C30 was used to evaluate the quality of life of MM patients, and their norms were as control. Factors which influencing the quality of life were investigated and analyzed with SPSS 17.0 software. Results The total score of quality of life in MM patients was 49.0 ___ 21.7 which was lower than the norms （60.7 ___ 23.4）. The scores on fatigue, nausea, vomiting, pain, short of breath, disturbance on sleeping, losing appetite, constipation, other symptoms and financial difficulty were significantly higher than data of the norms （P^O.05）. Factors as being elderly （especially those older than 70） , under higher proportion of medical costs on their own expense or financial difficulty etc., had major influences on the quality of life （P^0.05） of MM patients who in particular having worse quality of life when in worsening clinical ISS stage （P〈 0.05）. Low level of hemoglobin, high level of serum calcium and globulin all significantly reduced the quality of life of the MM patients （P〈0.05）. Conclusion The quality of life of MM patients was significantly lower than the normal people or patients with other tumors. Fatigue, pain, and financial difficulty were main influencing factors on the quality of life of MM patients. The assessment on the effects of treatment should relate to the improvement of hemoglobin, serum calcium and globulin, which could all improve the quality of life of MM patients.