儿童特应性皮炎治疗前后生活质量的评估

Evaluation of quality of life of children with atopic dermatitis before and after treatment

目的评估儿童特应性皮炎(AD)患儿及其家庭生活质量,并探讨治疗后其生活质量的改善情况。方法应用婴儿皮炎生活质量指数(IDQOL)、儿童皮炎生活质量指数(CDLQI)和皮炎家庭生活影响指数(DFI)问卷,对109例AD患儿和55例正常对照儿童进行生活质量评估,并应用AD的严重程度评分(SCORAD)对疾病严重程度评估。间断外用糖皮质激素治疗3个月后观察疗效和生活质量改善情况。结果 IDQOL和CDLQI问卷显示影响患儿较大的3个问题均是"瘙痒或搔抓""情绪"和"睡眠";DFI问卷显示影响患儿看护人较大的3个问题是"睡眠""疲劳度"和"情绪"。SCORAD评分与IDQOL、CDLQI评分呈正相关(分别r=0.358、0.386;P<0.05);在1~4岁患儿组SCORAD评分与DFI评分呈正相关(r=0.297,P<0.05)。治疗后患儿SCORAD评分明显下降(P<0.01),IDQOL/CDLQI及DFI评分均明显改善(P<0.05)。结论 AD对患儿及其家庭的生活质量有明显影响;外用糖皮质激素可控制疾病并改善患儿其家庭的生活质量。

Objective To investigate the quality of life of children with atopic dermatitis （AD） and their families, and to assess the changes in quality of life after treatment. Methods The Infants＇ Dermatitis Quality of Life Index （IDQOL）, Children＇s Dermatology Life Quality Index （CDLQI）, and Dermatitis Family Impact （DFI） questionnaires were used to evaluate quality of life in 109 children with AD and 55 normal children. The Severity Scoring of Atopic Dermatitis （SCORAD） was used to evaluate disease severity. The children were given external application of glucocorticoids according to the SCORAD index, and the clinical outcome and changes in quality of life were observed after 3 months of treatment. Results The three items in both IDQOL and CDLQI questionnaires with higher scores were itching/scratching, mood problems, and sleeping disturbance in the AD patients. Sleeping disturbance, fatigue and mood problems were the three items in the DFI questionnaire with higher scores. There was a positive correlation between IDQOL/CDLQI score and SCORAD index （r=0.358, 0.386 respectively; P〈0.05）. In the younger group （1-4 years）, there was a positive correlation between DFI score and SCORAD index （r=0.297; P〈0.05）. After treatment the severity of AD and quality of life in the children and their families （P〈O.05） were significantly improved. Conclusions AD has an adverse effect on quality of life in children with AD and their families. Topical glucocorticoids may control the symptoms of AD and improve the quality of life in children and theirfamilies.