合并症对慢性粒细胞白血病患者健康相关生活质量的影响

Effect of complications on HRQOL in patients with chronic myeloid leukemia

目的:探讨合并症对慢性粒细胞白血病(CML)患者健康相关生活质量(HRQOL)的影响。方法:选择87例CML患者的临床资料进行回顾性分析。分别采用简明健康状况调查表(SF-36)和Charlson合并症指数问卷(修改版)评估患者的HRQOL和合并症情况,并调查可能有助于解释患者HRQOL的疾病相关变量和社会人口变量。结果:87例患者中,31例(36%)报告没有任何合并症,28例(32%)报告只有1种合并症,28例(32%)报告有2种或更多种合并症。与出现1种合并症或2种或更多合并症患者相比,无合并症患者在SF-36的所有身体和精神健康量表上表现出具有统计学意义的更好结果(P<0.05)。多变量ANCOVA分析结果显示,在多重比较的Bonferroni校正后,合并症组的下列量表仍显著降低:健康感知(P<0.001),身体疼痛(P<0.001),身体机能(P=0.002)和活力(P=0.002)。结论:CML患者合并症的存在与身体和精神健康状况降低有关。因此,评估CML患者的合并症对于识别最需要改善HRQOL的人群非常重要。

Objective:To evaluate the effect of complications on HRQOL in patients with chronic myeloid leukemia(CML).Method:The clinical data of 87 CML patients were retrospectively analyzed.The 36-Item Short-Form Health Survey(SF-36) and Charlson’s Complication Index Questionnaire(revised version) were used to evaluate the HRQOL and complications of the patients.Key variables potentially contributing to explaining patient’s HRQOL were considered and these were selected based on clinical relevance for the purpose of this analysis.Result:Of the 87 patients,31 cases(36%) reported no complications,28 cases(32%) reported only one complication,and 28 cases(32%) reported two or more complications.Compared with patients with one or more complications,patients without complications showed better results on all the physical and mental health scales of the SF-36(P<0.05).Multivariate ANCOVA analysis showed that after Bonferroni correction of multiple comparisons,the following scales were significantly reduced in the complications group:health perception(P<0.001),body pain(P<0.001),body function(P=0.002) and vitality(P=0.002).Conclusion:The presence of complications in patients with CML is associated with reduced physical and mental health.Therefore,it is very important to assess the complications of patients in order to facilitate identification of those most in need of HRQOL improvements.