QLS-DSD与JOA评分量表在脊柱退行性疾病患者评分应用中的比较

A comparison between QLS-DSD and JOA scale in assessment of spinal degenerative disease

背景:脊柱退行性疾病的发病率日渐上升,目前我国对疾病病情及愈合的评估一直沿用国外的统计量表,因此制定一套适合我国国情的关于脊柱退行性疾病患者的评估量表成为当务之急。目的目的:比较脊椎生活量表(QLS-DSD)与汉化版JOA颈、腰椎评分量表在脊柱退行性疾病患者评价中的使用情况,评估两种量表的信度、区分效度和反应度。方法方法:采用横、纵联合调查法利用QLS-DSD与汉化版JOA颈、腰椎量表分别对符合纳入标准的44例颈椎和61例腰椎退行性疾病手术治疗患者进行问卷调查,采用Cronbachα系数和分半信度评价两类量表的信度;计算患者术前、术后各量表在各领域得分和总得分,再进行t检验分析,来评价量表的区分效度和反应度。结果结果:QLS-DSD总Cronbachα系数为0.891,总分半信度系数为0.908;JOA颈椎量表总Cronbachα系数为0.896,总分半信度系数为0.842;JOA腰椎量表总的Cronbachα系数为0.845,总分半信度系数为0.852。JOA量表在颈、腰椎患者手术前后的总分比较均有显著差异(P<0.05)。QLS-DSD仅在颈椎患者的手术前后总分中有显著差异(P<0.05),而在腰椎患者中差异无统计学意义(P>0.05)。结论结论:QLS-DSD和JOA量表一样其使用信度良好,故可将其用在临床上对脊柱疾病患者的评价中。但QLS-DSD主要是为评估脊柱退行性疾病患者生活质量而制定的,不能较好的反映手术治疗后短期内治疗效果,但通过观察其改变趋势,可预见QLS-DSD可以很好的反映术后较长时间内的治疗效果对患者生活质量的影响。

Background：The incidence of spinal degenerative diseases has been gradually increasing. Foreign statistical scale has been used for the assessment of the disease in China. Therefore it becomes imperative to develop a set of assessment scale for Chinese with spinal degenerative disease. 〈br〉 Objective：To compare Quality of Life Scale for Patients with Degenerative Spine Disease （QLS-DSD） with JOA scale in as-sessment of spinal degenerative disease. 〈br〉 Methods：Questionnaire （both QLS-DSD and JOA） survey was conducted in 44 patients with cervical degenerative disease and 61 patients with lumbar degenerative disease before and after surgical treatment. Reliability of the scales was evaluated by Cronbach alpha coefficient and split-half reliability evaluation. Then Student＆#39;s t-test was used to assess discrimination va-lidity and responsiveness. 〈br〉 Results：Total Cronbach alpha coefficient and total split-half reliability coefficient of QLS-DSD were 0.891 and 0.908, re-spectively. Total Cronbach alpha coefficient and total split-half reliability coefficient of JOA cervical scale were 0.896 and 0.842, respectively. Total Cronbach alpha coefficient and total split-half reliability coefficient of JOA lumbar scale were 0.845 and 0.852, respectively. There was significant difference in JOA cervical and lumbar scale scores between preopera-tive and postoperative assessment （P＆lt;0.05）. There was significant difference in total QLS-DSD score between preopera-tive and postoperative assessment in the patients with cervical degenerative disease （P＆lt;0.05）, but not in the patients with lumbar degenerative disease （P＆gt;0.05）. 〈br〉 Conclusions：Both QLS-DSD and JOA scale can be used in the clinical evaluation of patients with spinal disorders due to the good reliability. But the QLS-DSD cannot observe the improvement of the disease for the patients with lumbar degenera-tive disease in short-term after surgery.