肢端肥大症患者术后生活质量影响因素分析

Analysis of factors affecting postoperative quality of life of patients with acromegaly

目的分析肢端肥大症患者术后生活质量的相关影响因素。方法选择新疆维吾尔自治区人民医院2013年1月至2022年5月确诊肢端肥大症并在接受垂体瘤切除术后随访3个月的41例患者作为研究对象,收集其一般资料及生化检查结果。利用AcroQoL及SF-12量表分别对所有入组患者进行生活质量评分,分析患者术后生活质量的影响因素。结果在AcroQoL量表中,年龄、受教育程度、出现症状至手术的时间与心理评分呈正相关(P<0.05)。在AcroQoL量表中,受教育程度还与总得分、心理外貌得分呈正相关(P<0.05)。年龄与AcroQoL量表的心理人际关系评分呈正相关(P<0.05),职业类型影响了SF-12量表评分(P<0.05)。在AcroQoL量表中,生化缓解组患者的总得分、生理得分、心理得分均优于生化未缓解组(P<0.05,P<0.01,P<0.05)。在SF-12量表中,生化缓解组患者的身体得分优于生化未缓解组(P<0.01)。术前胰岛素样生长因子1(IGF-1)水平与心理得分呈负相关(P<0.05),在SF-12量表中,术前生长激素水平与生理、心理评分呈正相关(P<0.05),二次手术是SF-12量表评分的负向影响因素(P<0.05)。并发症数量对AcroQoL量表所有维度的评分都产生了负面影响(P<0.05)。散点图显示,随着术前IGF-1水平升高,AcroQoL量表得分呈下降趋势(P<0.05),而与SF-12量表评分无关(P>0.05)。垂体瘤的大小是SF-12量表心理评分的负向影响因素(P<0.05)。结论年龄、职业、受教育程度、二次手术、并发症数量、放疗、垂体瘤大小、出现症状至手术的时间均对肢端肥大症患者术后生活质量有影响,生化缓解可部分改善但不能完全逆转患者的术后生活质量。

Objective To analyze the related factors of postoperative quality of life in patients with acromegaly.Methods Forty-one patients with acromegaly diagnosed in People’s Hospital of Xinjiang Uygur Autonomous Region from January 2013 to May 2022 and followed up for 3 months after pituitary adenoma resection were selected as subjects to collect their general basic data and biochemical indexes.AcroQoL and SF-12 scale were used to score the quality of life of all patients,and the factors affecting the quality of life after operation were analyzed.Results In the AcroQOL scale,age,education level and the time from the onset of symptoms to operation were positively correlated with psychological score(P<0.05).In the AcroQOL scale,the level of education was positively correlated with the total score and the score of mental appearance(P<0.05).There was a positive correlation between age and the score of psychological interpersonal relationship of AcroQoL scale(P<0.05),and the type of occupation affected the score of SF-12 scale(P<0.05).In the AcroQOL scale,the total score,physiological score,and psychological score of the biochemical remission group were better than those of the biochemical non-remission group(P<0.05,P<0.01,P<0.05).In the SF-12 scale,the body score of the biochemical remission group was better than that of the biochemical non-remission group(P<0.01).The preoperative insulin like growth factor 1(IGF-1)level was negatively correlated with the psychological score(P<0.05).In the SF-12 scale,the preoperative growth hormone level level was positively correlated with the physiological and psychological scores(P<0.05),and the second operation was a negative factor affecting the SF-12 score(P<0.05).The number of complications had a negative effect on the scores of all dimensions of the AcroQoL scale(P<0.05).In the scatter plot,with the increase of the level of IGF-1 before operation,the score of the AcroQoL scale showed a downward trend(P<0.05),but had nothing to do with the score of SF-12 scale(P>0.05).The size of pituitary adenoma is a negative factor affecting the psychological score of SF-12 scale(P<0.05).Conclusion Age,occupation,education level,secondary operation,complication quan-tity,radio therapy,size of pituitary adenoma,and the time from the onset of symptoms to operation all affect the postoperative quality of life of patients with acromegaly.Biochemical remission can partially improve,but not completely reverse the postoperative quality of life of patients.