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克罗恩病直肠结肠炎缓解期的健康相关生活质量与普通人群无异。

Health related quality of life in Crohn's proctocolitis does not differ from a general population when in remission.

作者信息

Andersson P, Olaison G, Bendtsen P, Myrelid P, Sjödahl R

机构信息

Department of Surgery, Division of Colorectal Surgery, University Hospital, S-58185 Linköping, Sweden.

出版信息

Colorectal Dis. 2003 Jan;5(1):56-62. doi: 10.1046/j.1463-1318.2003.00407.x.

Abstract

OBJECTIVE

All treatment in Crohn's disease, although palliative, aims at restoring full health. The objective of this study was to compare health-related quality of life and psychosocial conditions in patients with Crohn's proctocolitis with a general population.

PATIENTS AND METHODS

One hundred and twenty-seven patients with Crohn's proctocolitis (median age 44 years, 44.1% men) were compared with 266 controls (median age 45 years, 50.7% men). A questionnaire consisting of the Short Form-36 (SF-36), the Psychological General Well-Being Index (PGWB) and a visual analogue scale (VAS) evaluating general health as well as questions regarding psychosocial conditions was used. Disease activity was evaluated by Best's modification of the classical Crohn's Disease Activity Index.

RESULTS

Patients in remission had a health related quality of life similar to controls according to the SF-36 apart from general health where scores were lower (P < 0.01). Patients with active disease scored lower in all aspects of the SF-36 (P < 0.001 or P < 0.0001) as well as the PGWB (P < 0.0001). In a model for multiple regression including age, gender, concomitant small bowel disease, permanent stoma, previous colonic surgery, disease activity, duration, and aggressiveness, disease activity was the only variable negatively predicting all 8 domains of the SF-36 in the patient group (P < 0.001). The mean annual sick-leave for patients and controls were 33.9 and 9.5 days (P < 0.0001), respectively. Sixty-eight percent of the patients and 78.4% of the controls (P = 0.04) were married or cohabited, 67.7% and 78.0% (P = 0.04), respectively, had children.

CONCLUSION

The health related quality of life for patients with Crohn's proctocolitis in remission does not differ from the general population. The disease has, however, a negative impact on parenthood, family life and professional performance.

摘要

目的

克罗恩病的所有治疗,尽管是姑息性的,但目标都是恢复完全健康。本研究的目的是比较克罗恩病直肠结肠炎患者与普通人群的健康相关生活质量和心理社会状况。

患者与方法

127例克罗恩病直肠结肠炎患者(中位年龄44岁,男性占44.1%)与266例对照者(中位年龄45岁,男性占50.7%)进行比较。使用了一份问卷,包括简短健康调查问卷(SF - 36)、心理总体幸福感指数(PGWB)以及一个评估总体健康的视觉模拟量表(VAS),还有关于心理社会状况的问题。疾病活动度通过对经典克罗恩病活动指数的贝斯特改良版进行评估。

结果

根据SF - 36,缓解期患者的健康相关生活质量与对照者相似,但总体健康方面得分较低(P < 0.01)。活动期疾病患者在SF - 36的所有方面得分均较低(P < 0.001或P < 0.0001),在PGWB方面也较低(P < 0.0001)。在一个多元回归模型中,纳入年龄、性别、合并小肠疾病、永久性造口、既往结肠手术、疾病活动度、病程和侵袭性等因素,疾病活动度是患者组中唯一对SF - 36的所有8个领域均有负向预测作用的变量(P < 0.001)。患者和对照者的年均病假天数分别为33.9天和9.5天(P < 0.0001)。68%的患者和78.4%的对照者(P = 0.04)已婚或同居,分别有67.7%和78.0%(P = 0.04)育有子女。

结论

缓解期克罗恩病直肠结肠炎患者的健康相关生活质量与普通人群无差异。然而,该疾病对生育、家庭生活和职业表现有负面影响。

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