大骨节病患者经济收入水平与生存质量的关系研究

Relationship between income level and quality of life in patients with Kashin-Beck disease

目的了解大骨节病患者经济收入与生存质量的现况,分析不同经济水平对生存质量的影响程度,为大骨节病精准扶贫的重点帮扶对象和目标收入水平选择提供依据。方法2017年5月至2019年5月在陕西省大骨节病历史重病区永寿县和麟游县,选择成年大骨节病患者作为调查对象,调查患者的家庭年收入水平及生存质量,应用中文版欧洲五维五水平健康量表(EQ-5D-5L)及其效用值转换体系计算患者的生存质量得分,并计算不同收入水平大骨节病患者的收入差与生存质量差之比。结果共有290例大骨节病患者参与调查,家庭年收入均值为11462.41元,其中低(<5000元)、中等(5000~10000元)、高收入(>10000元)组家庭年收入均值分别为2663.48、9262.75和28397.26元;低收入和中等收入组收入差与生存质量差之比在行动能力、日常活动、EQ指数方面(109.99×10^4、94.28×10^4、94.28×10^4)大于低收入和高等收入组(55.94×10^4、91.91×10^4、-3.20×10^3),其中低收入和中等收入组收入差与生存质量差之比在自我照顾、焦虑/沮丧和VAS得分为负值(-131.99×10^4、-65.99×10^4、-65.99×10^3)。结论大骨节病患者收入水平偏低且收入差距较大,以家庭年收入<10000元的大骨节病患者为扶贫对象、以家庭收入水平≥10000元为扶贫目标,可以更为明显地改善大骨节病患者的生存质量。

Objective To investigate the current situation of economic income and quality of life of patients with Kashin-Beck disease(KBD),and to analyze the impact of different economic levels on quality of life of patients with KBD,and to provide evidence for selection of target and key populations setting of poverty alleviation in KBD area.Methods The anrual family income and quality of life of adults with KBD in Yongshou County and Linyou County,Shaanxi Province were investigated from May 2017 to May 2019.Patient's quality of life were evaluated using Chinese version of European five-dimensional five-level health scale(EQ-5D-5L)and its utility value conversion system was used to calculate the EQ-index.The ratio of income difference to quality of life difference in different income KBD patients was calculated.Results A total of 290 patients with KBD participated in the survey.The average annual income of families with KBD was 11462.41 Yuan of which the average annual income of low(<5000 Yuan),medium(5000~10000 Yuan)and high-income(>10000 Yuan)groups was 2663.48,9262.75 and 28397.26 Yuan,respectively.The ratios of income difference to quality of life difference between low-income and medium-income groups(109.99×104,94.28×104,94.28×104)were bigger than the ratios of income difference to quality of life difference(55.94×104,91.91×104,-3.20×103)between low-income and high-income groups in terms of mobility,usual activity,and EQ-index.The ratios of income difference to quality of life difference were negative in terms of self care,anxiety/depression and VAS score(-131.99×104,-65.99×104,-65.99×103).Conclusions Patients with KBD have low income level and large income gap.The KBD patients whose annual income less than 10000 Yuan could be the key population of poverty alleviation,and family income level of more than 10000 Yuan could be the target of poverty alleviation.