老年糖尿病视网膜病变患者视觉相关生活质量评价及其影响因素

Evaluation of vision-related quality of life and its influencing factors in elderly patients with diabetic retinopathy

目的评价老年糖尿病视网膜病变(DR)患者视觉相关生活质量并分析其相关影响因素。方法选取2020年5月至2023年5月河北北方学院附属第一医院眼科收治的330例老年DR患者(纳入DR组)及310例老年2型糖尿病非DR患者(纳入非DR组),比较两组美国国家眼科研究所视功能相关生命质量量表(25-item National Eye Institute Visual Function Questionnaire,NEI-VFQ-25)评分,采用多元线性回归模型分析DR患者NEI-VFQ-25评分的独立影响因素,分析DR患者焦虑、抑郁、自我管理能力与视觉相关生活质量的相关性。采用SPSS 22.0软件进行数据分析。计量资料比较采用t或F检验。采用Pearson相关系数分析焦虑、抑郁、自我管理能力与视觉相关生活质量的相关性;采用多元线性回归模型分析老年DR患者视觉相关生活质量的影响因素。结果发放调查问卷640份,共回收有效问卷560份。分析发现,老年DR患者NEI-VFQ-25总分(64.79±14.21)分,其NEI-VFQ-25子量表评分及总分均低于非DR组(P<0.05);多元线性回归分析显示,严重病变(β=-0.253;P<0.001)、合并糖尿病性黄斑水肿(DME)(β=-0.224;P<0.001)、焦虑(β=-5.207;P=0.005)、抑郁(β=-5.534;P=0.004)、低自我管理能力(β=-6.942;P<0.001)可显著负向预测老年DR患者视觉相关生活质量;血糖控制达标(β=4.406;P=0.009)可显著正向预测老年DR患者视觉相关生活质量,回归方程显著(F=24.817;P<0.001)。Pearson相关性分析显示,老年DR患者NEI-VFQ-25评分与汉密尔顿焦虑量表、汉密尔顿抑郁量表呈负相关(r=-0.512、-0.488;P<0.001),与成人健康自我管理能力测评表评分呈正相关(r=0.652;P<0.001)。结论老年DR患者视觉相关生活质量降低,严重病变、DME、焦虑、抑郁、低自我管理能力为负向预测因素,血糖控制达标为正向预测因素。

Objective To evaluate the vision-related quality of life in the elderly patients with diabetic retinopathy(DR)and analyze its influencing factors.Methods A total of 330 elderly DR patients(DR group)and 310 elderly non-DR patients with type 2 diabetes mellitus(non-DR group)were selected from Department of Ophthalmology of the First Affiliated Hospital of Hebei North University from May 2020 to May 2023.The scores of 25-item National Eye Institute Visual Function Questionnaire(NEI-VFQ-25)were compared between the two groups.The multivariate linear regression model was used to analyze the independent influencing factors of NEI-VFQ-25 scores in the DR patients,and the correlation between anxiety,depression,self-management ability and vision-related quality of life in them was analyzed.SPSS 22.0 was used for statistical analysis.and t-or F-test was used for comparison of quantitative data.Pearson correlation coefficient was used to analyze the correlation between anxiety,depression,self-management ability,and visual related quality of life.A multiple linear regression model was used to analyze the influencing factors of vision-related quality of life in the DR elderly patients.Results Totally,640 questionnaires were distributed,and 560 valid questionnaires were collected.The analysis found that the total score of NEI-VFQ-25 in the DR group was(64.79±14.21)points,and the subscale scores and total score of NEI-VFQ-25 were lower than those in the non-DR group(P<0.05).Multivariate linear regression analysis showed that severe lesion(β=-0.253;P<0.001),complicated diabetic macular edema(DME)(β=-0.224;P<0.001),anxiety(β=-5.207;P=0.005),depression(β=-5.534;P=0.004),and low self-management ability(β=-6.942;P<0.001)could significantly negatively predict vision-related quality of life in the elderly DR patients,and that blood glucose control(β=4.406;P=0.009)could significantly positively predict vision-related quality of life in the DR elderly patients,and the regression equation was significant(F=24.817;P<0.001).Pearson correlation analysis showed that NEI-VFQ-25 score in the elderly DR patients was negatively correlated with Hamilton anxiety scale score and Hamilton depression scale score(r=-0.512,-0.488;P<0.001)and was positively correlated with the score of adult health self-management skill rating scale(r=0.652;P<0.001).Conclusion The vision-related quality of life in the elderly DR patients is reduced.The severity of lesion,DME,anxiety,depression and low self-management ability are negative predictors,and blood glucose control standard is a positive predictor.