慢性肝病患者的健康相关生存质量调查分析

Health-related quality of life in patients with chronic liver disease

目的:调查不同病因慢性肝病患者的健康相关生存质量,研究其与病因、疾病严重程度的关系,以及影响健康相关生存质量的因素。方法:392例慢性肝病患者,91例健康对照者参与调查。所有受试者回答SF-36中文版第二版(SF-36v2)量表,对生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康共8个维度,以及躯体健康和精神健康进行总评。应用协方差分析法对比不同病因和不同疾病严重程度受试者的健康相关生存质量评分;逐步线性回归分析受试者健康相关生存质量的影响因素。结果:慢性肝病患者SF-36v2量表各维度值及总评值显著低于健康对照组(P<0.05)。不同病因肝硬化患者SF-36v2量表各维度值及总评值之间无显著性差异(P>0.05)。慢性肝病患者随着疾病严重程度的加重,各维度值均下降,其中反映生理功能的维度值显著下降(P<0.05)。逐步线性回归分析显示年龄、性别、出现腹水、出现静脉曲张、总胆红素水平、凝血酶原时间及血红蛋白水平对SF-36v2多个维度值评分有重要影响。结论:慢性肝病患者健康相关生存质量明显下降。不同病因慢性肝病患者健康相关生存质量相似。慢性肝病患者随着疾病严重程度的加重,健康相关生存质量下降。

Objective：To investigate health-related quality of life （HRQOL）in patients with chronic liver dis- ease（CLD）and its influencing factors.Methods： HRQOL was measured with SF-36v2 Chinese version.A total of 392 Chinese patients with CLD and 91 healthy controls were enrolled.Demographic and clinical data were col- lected and patients with liver cirrhosis were divided into Child＇s Class A,B,and C according to Child-Tur- cotte-Pugh scoring system.Univariate analysis was used to compare the HRQOL scores of different groups,and stepwise linear regression analysis was used to investigate the HRQOL scores＇ demographic and clinical influ- encing factors.Results：HRQOL in patients with CLD was lower than that in healthy controls（P〈O.OS）.Different etiologies of CLD had the similar HRQOL （P〉O.O5）.Increasing severity of CLD from no cirrhosis to advanced cirrhosis was associated with a decrease on HRQOL,especially on physical domains of the SF-36v2 （P〈0.05）. Stepwise linear regression analysis showed that age,gender,ascites,varices,serum total bilirubin,prothrombin time and hemoglobin had significant effect on multiple domains of SF-36v2.Conclusion：Patients with CLD had reduced HRQOL.Different etiologies of CLD had the similar HRQOL and increasing severity of CLD was as- sociated with a decrease on HRQOL.Old age,female gender,ascites,varices,hyperbilirubinemia,and prolonging prothrombin time were important factors reducing HRQOL.