不同严重程度银屑病对患者生活质量的影响

The Impact of Severity of Psoriasis on Quality of Life in Psoriatic Patients

目的探讨不同严重程度银屑病对患者生活质量的影响。方法设计生活质量问卷,从日常生活、工作和学习、社会交往、心理等几个方面,调查504例18岁以上寻常性银屑病患者,由医生完成银屑病的严重度评价(PASI积分)。最后用SPSS统计软件对资料进行分析和整理。结果498例银屑病患者因病情轻重不同,对患者日常生活、社会交往、心理的影响不同。表现为饮食受限占63.3%,睡眠差占40.2%,穿衣受限占59.0%,使用公共交通工具及公用设施受影响占26.5%,理发或美容时遭到拒绝占15.1%,患者收入受到影响占31.2%;这些表现在病情严重的患者中更明显。皮损发生在阴股部的患者性生活受到极严重影响。银屑病患者在社交或其他公共场所感到不自在者占58.8%,与人交往的愿望受限占43.3%,不愿参加社会活动占29%,尽量避免与他人握手占25.8%;随病情加重愈加明显。54.9%的患者觉得自尊心受到伤害,总觉得别人在有意回避自己者占26.6%。64.4%的患者因为自己的银屑病焦虑不安,83.1%的患者经常担心银屑病会复发或加重。15.9%的患者曾有轻生的想法,中重度患者中比例增加。结论随着病情严重程度的增加,银屑病对患者的日常生活、工作学习、社会交往和心理的影响越大;应在生物-心理-社会医学的模式上治疗银屑病,除皮肤科躯体治疗外,传授疾病知识。

Objective To investigate the impact of severity of psoriasis on quality of life in patients with psoriasis vulgaris.Methods A questionnaire interview was carried out to the outpatients with psoriasis vulgaris(n=504)from Dec.2000to Sept.2001.All the patients were more than18years old.The content of questionnaire included daily life and activities,work and school performance,social activities and personal relationships,and psychologic status.Disease severity was assessed with psoriasis area and severity index(PASI).498patients were included for the final analysis.Statistical analysis was performed with SPSS software package.Results63.3%patients were restricted in their food selection.40.2%had bad sleep,59.0%could not dress short clothes in the summer.26.5%were restricted in use of public traffic and services.15.1%were rejected in haircut and cosmetic service.31.2%had decreased income along with severity of the disease.58.8%felt uncomfortable in social activities and public places.25.8%avoided handshaking with others.43.3%were reluctant in social intercourse.29.0%were not willing to take part in social activities,especially for moderate and severe cases.54.9%felt that their self-esteem was injured.26.6%thought that other peoples always avoided to meet them.64.4%felt anxiety for their disease.83.1%often worried about relapse or exacerbation of psoriasis.15.9%showed a tendency to commit suicide.Conclusions The more severe the disease is the more impact it may have on the daily life,work and school performance,social activities and personal relationship,and psychologic status in patients with psoriasis vulgaris.It is reccommended that besides the conventional treatment bio-psychic and social medical management be given to the patients especially for moderate and severe cases.