丙型肝炎患者健康相关生命质量现状及相关因素分析

Health-related quality of life and associated factors in hepatitis C patients

目的了解丙型肝炎(简称丙肝)患者健康相关生命质量现状并分析其相关因素,为提高丙肝患者健康相关生命质量及制定相关干预策略和措施提供依据。方法2022年7-9月,在云南省文山州和江苏省徐州市采用SF-36量表调查丙肝患者的健康相关生命质量状况。描述调查对象的社会人口学特征、病程、有无肝脏不适感和治疗等情况,采用t检验或方差分析进行组间比较,采用多元线性回归模型分析调查对象健康相关生命质量的相关因素。结果共招募486名研究对象,获得有效问卷483份(99.38%)。统计分析结果显示,在SF-36量表的8个维度中,生理功能维度得分最高,总体健康维度得分最低,生理健康综合得分为(71.90±22.77)分,心理健康综合得分为(72.83±20.00)分,治疗的患者健康相关生命质量略高于未治疗的患者。多元线性回归模型分析结果显示,在生理健康方面,<50岁(β=9.484,95%CI:5.831~13.137)、家庭人均月收入在1000~3000元者(β=8.797,95%CI:4.828~12.765)、3001~5000元者(β=14.817,95%CI:9.069~20.566)、>5000元者(β=9.592,95%CI:0.275~18.909)、未患其他疾病者(β=11.541,95%CI:7.922~15.159)、无肝脏不适者(β=12.055,95%CI:7.827~16.284)的得分更高;在心理健康方面,<50岁者(β=4.710,95%CI:1.165~8.255)、家庭人均月收入在3001~5000元者(β=10.923,95%CI:5.474~16.373)和>5000元者(β=8.695,95%CI:0.038~17.353)、未患其他疾病者(β=9.052,95%CI:5.678~12.426)、无肝脏不适者(β=9.482,95%CI:5.718~13.247)的得分更高,农民或民工(β=-7.795,95%CI:-8.881~-0.492)得分更低。结论抗病毒治疗能提高丙肝患者的健康相关生命质量,但不明显。需制定相关干预策略和措施降低丙肝对人体的危害,提高该人群的健康状况,尤其关注年龄大、收入低、患有其他疾病和出现肝脏不适感的患者。

Objective To understand the current situation of the health-related quality of life of hepatitis C patients and its related factors to provide a basis for improving the health-related quality of life of hepatitis C patients and formulating related intervention strategies and measures.Methods From July to September 2022,the SF-36 scale was used to investigate the health-related quality of life status of patients with hepatitis C in Wenshan Prefecture,Yunnan Province and Xuzhou City,Jiangsu Province.Sociodemographic characteristics,disease duration,presence of liver discomfort,and treatment of the survey subjects were described.T-test or ANOVA was used to compare between groups and multiple linear regression models were used to analyze the factors associated with the health-related quality of life of the survey subjects.Results 486 study subjects were recruited,with 483 valid questionnaires(99.38%).Among the eight dimensions of the SF-36 scale,the highest score was obtained for the physical function dimension and the lowest for the general health dimension,with a composite score of(71.90±22.77)for physical health and(72.83±20.00)for mental health.Treated patients had a slightly higher health-related quality of life than the untreated patients.The results of the multiple linear regression model analysis showed that in terms of physical health,those<50 years old(β=9.484,95%CI:5.831-13.137),monthly per capita household income of 1000-3000 RMB yuan(β=8.797,95%CI:4.828-12.765),3001-5000 RMB yuan(β=14.817,95%CI:9.069-20.566),>5000 RMB yuan(β=9.592,95%CI:0.275-18.909),without other diseases(β=11.541,95%CI:7.922-15.159)and without liver discomfort(β=12.055,95%CI:7.827-16.284)had higher scores.In terms of mental health,those<50 years old(β=4.710,95%CI:1.165-8.255),monthly per capita household income of 3001-5000 RMB yuan(β=10.923,95%CI:5.474-16.373)and those with>5000 RMB yuan(β=8.695,95%CI:0.038-17.353),without other diseases(β=9.052,95%CI:5.678-12.426),without liver discomfort(β=9.482,95%CI:5.718-13.247)had higher scores.Farmers or mineworkers(β=-7.795,95%CI:-8.881--0.492)had lower scores.Conclusions Antiviral treatment improves health-related quality of life in patients with hepatitis C,but not significantly.Intervention strategies and measures are needed to reduce the risk of hepatitis C and improve the health status of this population,with particular attention to older patients who have low income,suffer from other diseases,and experience liver discomfort.