成人斜视患者术前生存质量的研究

The Effects of Strabismus on Health-related Quality of Life in Adults

目的：研究成人斜视患者的健康相关生存质量，分析影响患者生存质量的因素。方法：调查研究。收集202例斜视患者（斜视组）和110例眼位正常者（眼位正常组），采用中文版成人斜视患者生存质量量表（CAS-20）评估患者的术前生存质量，同时记录患者年龄、性别、婚姻、斜视病程、职业等个体因素信息，及斜视类型和斜视度、复视与否、弱视与否等斜视特征信息。采用独立样本t检验、单因素方差分析、Pearson相关分析、多元线性回归分析等分析不同个体信息和不同斜视特征对患者术前生存质量的影响．结果：斜视组CAS．20得分为56．8±16．7，眼位正常组得分为98．0±4．3，2组差异有统计学意义（t=-35．2，P〈0．001）。斜视患者中伴复视者的视功能维度得分显著低于无复视者（t=-1．987，P=0．047）；伴弱视的斜视患者的总量表得分均显著低于不伴弱视者（t=-2．122，P=0．004）；水平斜视度〉25。者的社会心理维度得分低于斜视度≤25者（t=2．523，P=0．007）；不同偏斜方向的患者的生存质量得分无明显区别。年长斜视患者生存质量得分低于年轻斜视患者（r=-0．260，P〈0．001），病程长的患者的生存质量得分低于病程短的斜视患者（F=-0．142，P=0．035）；已婚患者量表得分显著低于未婚者（t=2．981，P=0．004）；非学生斜视患者比学生斜视患者的生存质量得分低（t=-2．084，P=0．038）。多元回归分析显示年龄、斜视病程和有无伴弱视是影响患者生存质量的主要影响因素。结论：成人斜视患者健康相关的生存质量明显差于眼位正常人群；已婚、非学生族群、伴复视者或伴弱视者的生存质量量表得分低；年龄、病程和是否伴弱视是影响斜视患者术前生存质量的主要因素。

Objective： To analyze the health-related quality of life （HRQOL） in adults with strabismus, and to identify the factors that affect the ttRQOL in strabismus patients. Methods： In this investigation study, 202 adults with strabismus and 110 healthy control adults were recruited. Participants were asked to complete the Chinese Adult Strabismus 20 scale （CAS-20） HRQOL assessment. The following individual information was recorded： type and degree of strabismus, diplopia, age, sex, and marital status. Independent samples t-tests, ANOVA, Pearson correlation analyses, multiple linear regression analyses were used to analyze the effects of strabismus on HRQOL in adults based on the CAS-20 score. Results： The mean CAS-20 score for strabismus adults was 56.8i16.7, while the score in the control group was 98.0a：4.3 （t=-35.2, P〈0.001）. The CAS-20 function score of patients with diplopia was significantly lower than that for patients without it （t=-1.987, P=0.047）. The CAS-20 mean scores were all significantly lower in patients with amblyopia （t=-2.122, P=0.004）. The psychosocial score of patients with a large horizontal strabismus （〉25 ） was significantly lower than those with a small horizontal strabismus （〈 25 A） （t=2.523, P=-0.007）. There were no significant differences among the different types of strabismus. Age and the course of strabismus were negatively correlated with the HRQOL in strabismus adults （1＂=-0.260, P〈 0.001; r= -0.142, P=0.035）. Married strabismus subjects had lower scores than unmarried subjects （t=2.981, P= 0.004）. Patients who were students had higher scores （t=-2.084, P=0.038）. A multifactor retrospective analysis showed that age and the course of the strabismus, with or without amblyopia, were the main factors affecting the HRQOL for strabismic adults. Conclusions： The HRQOL of adults with strabismus is worse than that for healthy adults. The CAS-20 function scores of patients with diplopia or amblyopia are significantly lower than for patients without diplopia or amblyopia. The course of strabismus, age and with or without amblyopia are important factors in HRQOL.