慢性腰痛患者躯体症状负担与健康相关生活质量的关系

Relationship between the burden of somatic symptoms and health-related quality of life in patients with chronic low back pain

目的探讨慢性腰痛患者躯体症状负担与其健康相关生活质量的关系。方法选择2016年1月~2018年3月在本院就诊的腰痛患者作为研究对象,采用躯体症状量表-8(SSS-8)进行躯体症状负担的量化评测,采用2条目健康问卷抑郁量表(PHQ-2)进行抑郁症状的量化评测,采用欧洲五维健康量表(EQ-5D)进行健康相关生活质量的量化评测。对SSS-8评分与PHQ-2评分和EQ-5D评分的相关性进行Spearman相关性分析;统计并对比不同分度SSS-8评分患者的临床资料,并采用多因素Logistic分析影响EQ-5D评分的相关因素,以验证躯体症状(SSS-8评分)是否为健康相关生活质量(EQ-5D评分)的独立影响因素。结果不同SSS-8分度患者PHQ-2、EQ-5D评分之间均存在显著统计学差异(P<0.05);相关性分析显示,SSS-8分度与PHQ-2评分呈正相关(r=0.572,P<0.001),与EQ-5D评分呈负相关(r=-0.814,P<0.001)。不同性别和体质量指数患者的SSS-8分度相比较,差异无统计学意义(P>0.05);不同年龄、是否吸烟、婚姻状态、教育状态、是否规律锻炼、合并疾病种类、是否合并慢性膝部疼痛、不同程度VAS评分等患者的SSS-8分度存在统计学差异(P<0.05)。多因素Logisitc回归分析显示:SSS-8评分为Ⅰ-Ⅱ度、VAS评分>4分、合并疾病种类≥2种,是影响EQ-5D评分降低的风险因素;规律锻炼是EQ-5D评分降低的保护因素(P<0.05)。结论躯体症状是影响慢性腰痛患者生活质量的风险因素,临床应注意对躯体症状的评估,制定针对性的干预方案,以改善患者的预后。

Objective To investigate the relationship between the burden of somatic symptoms and health-related quality of life (QOL) in patients with chronic low back pain. Methods Patients with low back pain in our hospital from January 2016 to March 2018 were selected. Somatosomatic symptom scale 8 (SSS-8) was used to evaluate the burden of somatic symptoms. Health questionnaire depression scale (PHQ-2) was used to quantify depression symptoms, and European five-dimensional health scale (EQ-5D) was used to quantify health-related QOL. The correlation between SSS-8 score, PHQ-2 score and EQ-5D score was analyzed by Spearman analysis. The clinical data of patients with different SSS-8 scores were analyzed and compared, and the factors influencing EQ-5D scores were analyzed by multivariate Logistic analysis. To verify whether somatic symptom (SSS-8 score) was an independent influencing factor of health-related quality of life (EQ-5D score). Results There were significant differences in PHQ-2,EQ-5D scores among patients with different SSS-8 scores ( P <0.05), and there was a positive correlation between SSS-8 scores and PHQ-2 scores ( r =0.572, P <0.001). There was a negative correlation with EQ-5D score ( r =0.814, P <0.001). There was no significant difference in SSS-8 score between different sex and body mass index ( P >0.05). There were statistically significant differences in SSS-8 scores of patients with different ages, smoking, marital status, educational status, regular exercise, complicated diseases, chronic knee pain and VAS scores of different degrees ( P <0.05). Multi-factor Logistic analysis showed that SSS-8 score was Ⅰ-Ⅱ degree, VAS score was more than 4, and complicated diseases were more than 2 kinds. Regular exercise was the protective factor for the decrease of EQ-5D score ( P <0.05). Conclusion Somatic symptoms are risk factors affecting the QOL of patients with chronic low back pain. Clinical scholars should pay attention to the evaluation of somatic symptoms and formulate specific intervention plans to improve the prognosis of patients with chronic low back pain.