南充市社区脑梗死患者生活质量及其影响因素调查

Investigation on the Quality of Life and Its Influencing Factors among Cerebral Infarction Patients of Communities in Nanchong City 1

目的了解四川省南充市社区脑梗死患者生活质量的现状,并探讨其影响因素。方法随机整群抽取南充市辖区内10个社区被确诊治疗的脑梗死患者164例(脑梗死组),用汉密尔顿焦虑抑郁量表、残障评定量表、Barthel指数评定量表及生活质量量表简表(SF-36)进行调查。结果患者生活质量8个维度得分均低于四川省城乡居民SF-36评价值,且差异有显著统计学意义(P<0.001);经单因素分析发现,性别、年龄、婚姻状况和合并慢性疾病对SF-36总分及多个维度得分有显著影响(P<0.05);线性相关分析显示,除躯体疼痛外,SF-36总分及各维度得分与焦虑、抑郁和残障评定量表得分呈负相关关系(P<0.05),与Barthel指数评定量表总分呈正相关关系(P<0.05);多元线性回归分析发现,年龄、合并慢性疾病和焦虑、抑郁、残障评定量表及Barthel指数总分对社区脑梗死患者生活质量有显著影响(P<0.05)。结论南充市社区脑梗死患者生活质量较低;在临床治疗中关注焦虑、抑郁及合并慢性疾病的管控及改善患者功能状态是提高生活质量的关键。

Aim To investigate the quality of life and its influence factors among cerebral infarction patients of communities in Nanchong city. Methods Adopting general condition questionnaire, Hamilton Depression Scale（HAMD）, Hamilton Anxiety Scale（HAMA）, Modified Rankin Scale（MRS）, Barthel Index（BI） rating scale and Medical outcomes study short form 36 scale（SF-36）, a self-reported questionnaire survey was conducted among 164 cerebral infarction patients. Results The scores of eight dimensions of the SF-36 were significantly lower in the cerebral infarction patients than those in urban and rural residents of Sichuan province（P〈0.001）. Univariate analysis showed that sex, age, marital status and comorbidities significantly influenced scores of SF-36 and its several dimensions（P〈0.05）. Except the dimension body pain, the total scores of SF-36 and all other dimensions were negatively correlated withscores of HAMA, HAMD and MRS, and positively correlated with scores of BI rating scale（P〈0.05）. Excluding the interrelationships among each other factor, multivariate linear regression analysis showed age, comorbidities,scores of HAMA, HAMD,MRS and BI rating scale were main factors influencing quality of life（P〈0.05）. Conclusion The cerebral infarction patients of communities in Nanchong city have poor quality of life. Better managing and controlling comorbidities, anxiety and depression, and improving functional status are the key measures to improve the patients quality of life.