慢性痛风性关节炎患者健康相关生命质量及影响因素分析

Health-related quality of life and influencing factors in patients with chronic gouty arthritis

目的调查慢性痛风性关节炎(CGA)患者健康相关生命质量(HRQOL),并探讨其影响因素。方法选取2012年6月至2015年6月第三军医大学西南医院内分泌科收治的157例CGA患者进行调查,使用抑郁自评量表(SDS)评估CGA患者抑郁状况,使用简明健康调查问卷(SF-36)测量患者的HRQOL分数,并使用单因素方差分析和多元逐步线性回归统计方法对HRQOL的影响因素进行分析。结果 SDS评分结果显示抑郁症状82例(52.3%),其中轻度抑郁54例(34.4%),中度抑郁18例(11.5%),重度抑郁10例(6.4%)。统计结果显示SDS评分、年龄、性别、治疗处理、锻炼、医保类型、饮酒、饮食控制、睡眠质量可影响HRQOL得分,其中治疗处理、饮食控制、锻炼、SDS评分、年龄是主要影响因素,偏回归系数分别为17.14、16.33、15.75、-14.24、-13.96。结论 CGA患者大部分有抑郁症状,整体健康相关生命质量不容乐观。应关注年龄偏大和男性患者的治疗,饮食控制、戒酒、积极接受治疗处理、重视心理治疗、加强锻炼、改善睡眠质量以及扩大居民医保范围可以改善患者生命质量。

Objective To analyze the health-related quality of life(HRQOL) in patients with chronic gouty arthritis(CGA), and to study the influencing factors of HRQOL. Methods A total of 157 patients with CGA who were treated in Departments of Endocrinology of Southwest Hospital, Third Military Medical University from June2012 to June 2015 were selected as research subjects. Self-rating Depression Scale(SDS) was used to assess degree of depression in patients with CGA, and 36-Item Short Form Health Survey(SF-36) was applied to assess the HRQOL of these patients. One-way ANOVA and stepwise regression analysis were used to study the influence factors of HRQOL. Results SDS scores showed that there were 82 patients with depressive symptoms(52.3%), including 54(34.4%) patients of mild depression, 18 patients(11.5%) of moderate depression, 10 patients(6.4%) of severe depression. Stepwise regression analysis showed that SDS score, age, sex, treatment, physical exercise, health insurance, alcohol consumption, diet control and sleep quality influenced the HRQOL scores of patients, and treatment, diet control,physical exercise, SDS score and age were the main influencing factors, with the unstandardized coefficients of 17.14,16.33, 15.75,-14.24,-13.96. Conclusion Most of patients with CGA suffer from depressive symptoms, and the HRQOL scores of them is not optimistic. More attention must be paid to the elderly and male patients. Diet control, quitting drinking, receiving treatment, psychological treatment, strengthen exercise, improving sleep quality and expanding the scope of medical insurance all can improve patients’ quality of life.