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摘要:
目的 通过健康状况调查问卷SF-36量表评估肺血栓栓塞症(pulmonary thromboembolism,PTE)患者的生活质量并研究影响评分的相关因素。 方法 2016年5月至2017年11月在北京协和医院住院或呼吸内科门诊就诊的PTE患者受邀填写SF-36量表,并与中国普通人群比对。填写问卷的同时收集患者人口学资料(性别、年龄和肥胖状况)和临床资料[间隔时间(从诊断PTE时间至填表时间)、栓塞部位、深静脉血栓、癌症、慢性心肺疾病、诱发型PTE、一过性危险因素及永久性危险因素),通过单因素及多因素线性回归分析明确这些变量与生活质量评分的相关性。 结果 88例符合入选排除标准的PTE患者完成SF-36量表并纳入最终分析。PTE患者SF-36量表各维度评分均低于中国普通人群:生理机能评分59.8±27.4比87.6±16.8,生理职能30.4±41.9比83.0±20.7,躯体疼痛67.4±23.6比83.3±19.7,一般健康状况43.0± 23.1比68.2±19.4,精力57.3±23.5比70.1±16.8,社会功能60.1±29.9比84.8±16.6,情感职能44.7±43.1比85.3±17.7,精神健康58.7±21.5比78.8±15.4,各维度比较均有统计学差异(P均<0.01)。除精神健康这一变量外,PTE发生1年以上组各项生活质量评分均高于PTE发生1年内组。多因素线性回归分析显示,年龄和诱发型PTE与一般健康状况相关,间隔时间与躯体疼痛相关,一过性危险因素与生理机能、精力、社会功能及健康状况相关,而永久性危险因素则与精神健康相关。 结论 PTE患者生活质量低于普通人群,年龄、间隔时间、诱发型PTE、一过性危险因素和永久性危险因素与PTE患者生活质量相关。 Abstract:Objective The aim of this study was to evaluate the quality of life in patients with pulmonary thromboembolism (PTE) by the SF-36 questionnaire and to investigate the determinants of the quality of life. Methods PTE patients who had discharged from Peking Union Medical College Hospital or had visited the Department of Respiratory Medicine between May 2016 and November 2017 were invited to fill the SF-36 question- naire. The Results were compared with the normal Chinese population. Demographic (gender, age, and obesity)and clinical data (the interval from PTE to questionnaire, locations of thrombus, deep vein thrombosis, cancer, chronic heart/pulmonary disease, provoked PTE, transient risk factor, and permanent risk factor) were collected and determinants were analyzed with the univariate and multivariate regression. Results Eighty-eight patients finished the SF-36 questionnaire. PTE patients had lower subscale scores of SF-36 compared with normal Chinese people: physical functioning, 59.8±27.4 vs. 87.6±16.8; role-physical, 30.4±41.9 vs. 83.0±20.7; bodily pain, 67.4±23.6 vs. 83.3±19.7; general health, 43.0±23.1 vs. 68.2±19.4; vitality, 57.3±23.5 vs. 70.1±16.8; social functioning, 60.1±29.9 vs. 84.8±16.6; role-emotional, 44.7±43.1 vs. 85.3±17.7; and mental health, 58.7±21.5 vs. 78.8±15.4 (all P < 0.01). The life quality scores of PTE that occurred more than one year before were higher than those of PTE within one year in every subscale except mental health. Multivariate regression analysis showed that: Age and provoked PTE were associated with general health; the interval from the diagnosis of PTE to questionnaire was associated with bodily pain; the transient risk factor was associated with role-physical, vitality, social functioning, health transition; and the permanent risk factor was associated with mental health. Conclusions The quality of life in PTE patients is generally lower than that in normal Chinese population; age, interval, provoked PTE, transient risk factor, and permanent risk factor are associated with their quality of life. -
Key words:
- pulmonary thromboembolism /
- quality of life /
- SF-36 questionnaire
利益冲突 无 -
表 1 PTE患者SF-36量表各维度评分
维度 全部PTE患者(n=88) PTE≤1年(n=73) PTE>1年(n=15) P值 生理机能 59.8±27.4 57.5±26.7 71.0±28.4 0.0811 生理职能 30.4±41.9 25.7±39.5 53.3±47.1 0.0193 躯体疼痛 67.4±23.6 65.3±24.1 77.5±18.8 0.0684 一般健康状况 43.0±23.1 41.3±22.6 51.3±24.5 0.1275 精力 57.3±23.5 55.8±22.4 64.3±28.3 0.2047 社会功能 60.1±29.9 58.4±29.9 68.1±30.0 0.2559 情感职能 44.7±43.1 41.6±42.6 60.0±44.0 0.1333 精神健康 58.7±21.5 58.9±21.6 57.9±22.1 0.8711 健康变化 37.8±36.2 35.3±37.0 50.0±29.9 0.1527 PTE:肺血栓栓塞症 表 2 PTE患者SF-36量表各维度评分及与中国普通人群的比较
维度 中国普通人群[4]
(n=4251)PTE患者
(n=88)差值 P值 生理机能 87.6±16.8 59.8±27.4 27.8 <0.01 生理职能 83.0±20.7 30.4±41.9 52.6 <0.01 躯体疼痛 83.3±19.7 67.4±23.6 15.9 <0.01 一般健康状况 68.2±19.4 43.0±23.1 25.2 <0.01 精力 70.1±16.8 57.3±23.5 12.8 <0.01 社会功能 84.8±16.6 60.1±29.9 24.7 <0.01 情感职能 85.3±17.7 44.7±43.1 40.6 <0.01 精神健康 78.8±15.4 58.7±21.5 20.1 <0.01 健康变化 - 37.8±36.2 - - PTE:同表 1 -
[1] Konstantinides SV, Torbicki A, Agnelli G, et al. 2014 ESC guidelines on the diagnosis and management of acute pulmon-ary embolism[J]. Eur Heart J, 2014, 35: 3033-3069. doi: 10.1093/eurheartj/ehu283 [2] Reyes ME, Ye Y, Zhou Y, et al. Predictors of health-related quality of life and association with survival may identify colorectal cancer patients at high risk of poor prognosis[J]. Qual Life Res, 2017, 26: 319-330. doi: 10.1007/s11136-016-1381-8 [3] Kaptein AA, Scharloo M, Fischer MJ, et al. 50 years of psychological research on patients with COPD—road to ruin or highway to heaven?[J]. Respir Med, 2009, 103: 3-11. doi: 10.1016/j.rmed.2008.08.019 [4] 姜敏敏, 李鲁, 王红妹. SF-36 v2量表中国人群常模研究[J].中华预防医学会第三届学术年会暨中华预防医学会科学技术奖颁奖大会、世界公共卫生联盟第一届西太区公共卫生大会、全球华人公共卫生协会第五届年会论文集, 2009: 214. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=8051241 [5] 申希平, 丁建生, 李娟生, 等.在SPSS中利用均数和标准差做两独立样本t检验[J].现代预防医学, 2007, 34: 4066-4067. doi: 10.3969/j.issn.1003-8507.2007.21.025 [6] Klok FA, van Kralingen KW, van Dijk AP, et al. Quality of life in long-term survivors of acute pulmonary embolism[J]. Chest, 2010, 138: 1432-1440. doi: 10.1378/chest.09-2482 [7] van Es J, den Exter PL, Kaptein AA, et al. Quality of life after pulmonary embolism as assessed with SF-36 and PEmb-QoL[J]. Thromb Res, 2013, 132: 500-505. doi: 10.1016/j.thromres.2013.06.016 [8] Tavoly M, Utne KK, Jelsness-Jorgensen LP, et al. Health-related quality of life after pulmonary embolism: a cross-sectional study[J]. BMJ Open, 2016, 6: e013086. [9] Sista AK, Miller LE, Kahn SR, et al. Persistent right ventricular dysfunction, functional capacity limitation, exercise intolerance, and quality of life impairment following pulmonary embolism: systematic review with meta-analysis[J]. Vasc Med, 2017, 22: 37-43. doi: 10.1177/1358863X16670250 [10] Lubberts B, Paulino Pereira NR, Kabrhel C, et al. What is the effect of venous thromboembolism and related complica-tions on patient reported health-related quality of life? A meta-analysis[J]. Thromb Haemost, 2016, 116: 417-431. doi: 10.1160/TH16-02-0152 [11] Kahn SR, Hirsch AM, Akaberi A, et al. Functional and exercise limitations after a first episode of pulmonary embolism: results of the ELOPE Prospective Cohort Study[J]. Chest, 2017, 151: 1058-1068. doi: 10.1016/j.chest.2016.11.030 [12] Kahn SR, Akaberi A, Granton JT, et al. Quality of life, dyspnea, and functional exercise capacity following a first episode of pulmonary embolism: results of the ELOPE Cohort Study[J]. Am J Med, 2017, 130: 990.e9-e990.e21. https://www.ncbi.nlm.nih.gov/pubmed/28400247 [13] 刘春萍, 张丽华, 李俊峡, 等.急性PTE患者生活质量及其影响因素调查[J].中国循证心血管医学杂志, 2012, 4: 228-230. doi: 10.3969/j.issn.1674-4055.2012.03.014 [14] Kahn SR, Shbaklo H, Lamping DL, et al. Determinants of health-related quality of life during the 2 years following deep vein thrombosis[J]. J Thromb Haemost, 2008, 6: 1105-1112. doi: 10.1111/j.1538-7836.2008.03002.x [15] Klok FA, Cohn DM, Middeldorp S, et al. Quality of life after pulmonary embolism: validation of the PEmb-QoL Questionnaire[J]. J Thromb Haemost, 2010, 8: 523-532. doi: 10.1111/j.1538-7836.2009.03726.x [16] Cohn DM, Nelis EA, Busweiler LA, et al. Quality of life after pulmonary embolism: the development of the PEmb-QoL questionnaire[J]. J Thromb Haemost, 2009, 7: 1044-1046. doi: 10.1111/j.1538-7836.2009.03341.x -

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