冠心病患者共病状态与生活质量的相关性研究

Correlation research of comorbidity status and life quality in patients with coronary disease

目的：通过疾病累计评分量表（CIRS）和欧洲五维健康量表（EQ-5D）评价冠心病患者共病状态程度与生活质量,探讨共病状态和生活质量的相关性。方法选择2013年7月—2014年6月在心血管内科住院1周以上且入院时护理等级为一级的212例冠心病患者为调查对象,分别应用CIRS和EQ-5D对患者进行评分,并记录患者的生化指标、住院天数和费用等,分析共病状态与生活质量之间的关系。结果冠心病患者共病状态严重,分布在各个系统,同时生活质量下降,入院时CIRS评分总分为（20.36±6.36）分,严重指数为（1.45±0.45）,共病指数为（6.59±2.23）；EQ-5D总分为（10.83±2.86）分,直观式健康量表（VAS）得分为（44.29±23.17）分。 CIRS评分分级不同的患者,其EQ-5D评分、VAS评分、住院天数和住院费用的差异均有统计学意义（P〈0.01）。入院1周后,CIRS评分低组患者改护理级别为“二级护理”的例数更多,差异有统计学意义（P〈0.01）。 CIRS评分与EQ-5D评分、住院天数、住院费用、空腹血糖、血肌酐等均呈正相关,与VAS评分呈负相关（ r值分别为0.842,0.802,0.292,0.148,0．323,-0.531；P〈0.05）。结论冠心病患者共病状态与生活质量呈负相关,CIRS的应用可以客观评价共病状态的严重程度。

Objective To explore the correlation of comorbitidy status and life quality in coronary disease （ CD） patients by the cumulative illness rating scale （ CIRS） and Europe health-related quality of life questionnaire -5 Dimension （EQ-5D）. Methods A total of 212 CD patients, who hospitalized in Department of Cardiovascular over one week and had over level one care as the survey objects, applied CIRS and EQ-5D, documented biochemical norm, days of hospitalization and expenditure, and were analyzed the correlation between comorbitidy status and life quality. Results The CD patients stayed a serious status of cormorbitidy, distributed in different system and was reduced quality of life. The total score of CIRS was （20. 36 ± 6. 36） when admitted, severity norm was （1. 45 ± 0. 45）, comorbitidy norm was （6. 59 ± 2. 23）, while total score of EQ-5D was （10. 83± 2. 86）, in which VAS was （44. 29 ± 23. 17） score. Different level of CIRS patients, there were statistically significant on EQ-5D, VAS, days of hospitalization, and expenditure （P〈0. 01）. After one week admission, the low score of CIRS patients had more people change to level two care with statistical significance （P〈0.01）. The score of CIRS had positive correlation with EQ-5D, days of hospitalization, expenditure, fasting blood glucose and serum creatinine, and negative correlation with VAS （r=0. 842,0. 802, 0. 292,0. 148,0. 323,-0. 531;P〈0. 05）. Conclusions The comorbidity status has negative correlation with life quality in CD patients, and the CIRS can assess the severity of comorbidity status objectively.