慢性乙型肝炎患者生存质量的测量与评价

Assessment of quality of life in quality of life in patient with chronic hepatitis B

目的 测量并评价慢性乙型肝炎患者的生存质量 (QOL)。方法 采用SF 36量表 ,对 2 6 0例慢性乙型肝炎患者和 2 6 0例正常对照进行QOL测量与评价 ,并对QOL的影响因素进行单因素分析和多因素逐步回归分析。结果 慢性乙型肝炎患者的平均SF 36总评分及生理机能、角色生理状况、心理健康状况、角色心理状况、社会机能、活力、躯体疼痛和主观健康状况的平均评分分别为 5 6± 17、6 5± 2 4、2 1± 30、6 2± 18、2 8± 34、5 5± 2 8、5 7± 2、6 8± 2 5和 5 2± 16 ,与对照组相比 ,差异有非常显著性 (P均 <0 .0 1)。慢性乙型肝炎患者的平均生存质量指数评分 (7.2± 2 .2 )与对照组相比 ,差异有非常显著性 (P <0 .0 1)。慢性乙型肝炎患者SF 36总评分及其 8个分项目相互之间的相关系数均具有显著性意义 (P <0 .0 1)。SF 36总评分与生存质量指数评分呈极显著性正相关 (r =0 .7841,P <0 .0 0 1) ;影响慢性乙型肝炎患者QOL的主要因素是临床分型、乏力、腹水、黄疸、脾肿大、血清ALT与总胆红素 (TBil)升高、血浆白蛋白或 (A/G )降低以及HBeAg、HBV DNA持续阳性等。结论 SF

Objective To measure and assess the quality of life (QOL) of patients with chronic hepatitis B(CHB). Methods QOL of 260 patients with CHB and 260 healthy controls were evaluated by Mos SF 36, and QLI scores, single and multiple stepwise regression analysis were made to assess the factors affecting QLI.Results The average total score of SF 36,individual physiologic function, physical and mental health, emotional and social status,vitality,trunkal aching and general health were 56±17, 65±24, 21±30, 62±18, 28±34, 55±28, 57±23, 68±25 and 52±16,respectively in the CHB group,There were statistically significant differences between CHB group and the control group ( P values all <0.01). The average of QLI was 7.2±2.2 in the CHB group, and significant differences were also found as compared with that of the controls ( P <0.01). There were statistically signiticant correlation coefficients among the total score of SF 36 and the scores of each of the above 8 items in patients with CHB. The total score of SF 36 and scoring of QLI were positively correlative( r = 0.7841 , P <0.001). The factors affecting the scores of SF 36 of these patients were mainly: clinical pattern, weakness, ascites, jaundice, splenomegaly, elevation of serum ALT and total bilirubin,decrement of plasma and ALB, continued positivity of HBeAg and HBV DNA etc. Conclusion The SF 36 score was eligible for assesement of QOL of patients with CHB.