膝骨关节炎患者生活质量主要维度的相关因素分析

Analysis of Related Factors in Main Dimensions of Quality of Life of Patients with Knee Osteoarthritis

目的探讨膝骨关节炎(KOA)患者生活质量各维度改变及影响主要维度的因素。方法纳入新疆生产建设兵团第六师奇台医院2014年8月~2019年11月首诊的膝关节炎患者187例为病例组,同时期选取健康体检者203人作为对照组。收集两组研究对象一般临床资料,包括性别、年龄、婚姻、体重指数(BMI)、文化程度、职业、吸烟史、居住史、家庭年收入、既往病史、骨密度(BMD)。利用健康调查简表(SF-36)评价两组研究对象的一般健康、生理机能、生理职能、情感职能、躯体疼痛、社会活动、活力状态、精神健康8个维度的生活状况。以病例组SF-36量表评分最低的3个主要维度作为因变量,将危险因素作为自变量,分析影响上述维度的主要风险因素。结果两组年龄、BMI、BMD、性别、体力劳动及独居史情况比较,差异有统计学意义(P<0.05);病例组SF-36总分为(43.69±13.36)分,低于对照组的(77.03±16.53)分(t=-21.793,P=0.000),其中病例组分数最低的3个维度分别为躯体疼痛、生理职能和情感职能(F=21.379,P=0.000)。BMD与躯体疼痛、生理职能评分呈正相关(t=3.827、3.046,P=0.004、0.007),独居史阳性与情感职能评分呈负相关(t=0.000,P=0.033)。结论KOA的发生可能与高龄、高BMI、低BMD、女性、体力劳动及独居史阳性有关,且KOA患者的生活质量降低,主要体现在躯体疼痛、生理职能和情感职能3个方面,建议加强BMD的监测及给予更多的家庭及社会的支持。

Objective To explore the changes in various dimensions of the quality of life of patients with knee osteoarthritis(KOA)and the factors affecting the main dimensions.Methods A total of 187 patients with knee arthritis who were first diagnosed in Qitai Hospital of the Sixth Division of Xinjiang Production and Construction Corps from August 2014 to November 2019 were included as the case group,and 203 healthy persons were selected as the control group.The general clinical data of the two groups of research subjects were collected,including gender,age,marriage,body mass index(BMI),education level,occupation,smoking history,residence history,family annual income,past medical history,and bone mineral density(BMD).The health survey summary(SF-36)was used to evaluate the life status of the two groups of subjects in the eight dimensions of general health,physiological function,physiological function,emotional function,physical pain,social activity,vitality,and mental health.The three main dimensions with the lowest scores on the SF-36 scale of the case group were used as dependent variables,and risk factors were used as independent variables to analyze the main risk factors affecting the above dimensions.Results The difference in age,BMI,BMD,gender,physical labor and history of living alone between the two groups was statistically significant(P<0.05);the total score of SF-36 in the case group was(43.69±13.36),which was lower than that of the control group(77.03±16.53)(t=-21.793,P=0.000).The three dimensions with the lowest number of cases are physical pain,physiological function and emotional function(F=21.379,P=0.000).BMD was positively correlated with body pain and physiological function scores(t=3.827,3.046,P=0.004,0.007),and positive living alone history was negatively correlated with emotional function scores(t=0.000,P=0.033).Conclusion The occurrence of KOA might be related to advanced age,high BMI,low BMD,female,physical labor and a positive history of living alone,and the quality of life of KOA patients was reduced,which was mainly reflected in three aspects of physical pain,physiological function and emotional function.It was recommended to strengthen BMD Monitoring and giving more family and social support.