Bloemenkamp Daisy G M, Mali Willem P Th M, Tanis Bea C, van den Bosch Maurice A A J, Kemmeren Jeanet M, Algra Ale, van der Graaf Yolanda
Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.
J Vasc Surg. 2003 Jul;38(1):104-10. doi: 10.1016/s0741-5214(02)75465-7.
This study was undertaken to investigate the extent to which health-related quality of life (HQOL) is reduced in young women with peripheral arterial disease (PAD) compared with age-matched and gender-matched control subjects. Moreover, potential determinants of HQOL in young women with PAD were studied, ie, traditional cardiovascular risk factors, location of stenosis and time since diagnosis.
This was a population-based case-control study. Subjects were 208 young (<50 years) women with PAD diagnosed at angiography and 471 population-based age-matched and gender-matched control subjects. All participants completed the RAND-36 questionnaire, which produces a HQOL profile. The questionnaire contains 36 items that assess 8 domains of HQOL. Each domain is given a mean score ranging from 0 to 100, with higher scores indicative of better quality of life.
PAD had a deleterious effect on HQOL in young women. Ability to deal with the physical requirements of daily life was affected, and physical capabilities limited activity to a considerable extent. Mean differences observed for 2 domains, ie, Physical functioning and Role-physical, were -25.1 (95% confidence interval [CI], -28.8,-21.4) and -22.5 (95% CI, -28.9,-16.0). Within the group of young women with PAD, HQOL did not depend on age, smoking, hypercholesterolemia, or education. However, women with hyperglycemia, hypertension, or increased body mass index scored lower on 1 or more domains of RAND-36. Location of stenosis was also related to HQOL; patients with more proximal stenosis scored slightly higher on the domain Physical functioning, compared with women with more distal stenosis. Time (0-10 years) between diagnosis (1990-1999) and when RAND-36 was filled out (2000) is related to score on the Mental health domain; score increases over time. Scores on the other 7 domains of HQOL showed no significant relation to duration of disease.
Quality of life in young women with PAD was statistically significant diminished for all domains of RAND-36 in comparison with HQOL in healthy age-matched control subjects. HQOL of patients with recently diagnosed PAD is comparable to that of patients in whom the diagnosis was made several years previously. Effective therapy might stabilize, albeit not improve, quality of life in this specific patient population.
本研究旨在调查与年龄和性别匹配的对照受试者相比,外周动脉疾病(PAD)年轻女性的健康相关生活质量(HQOL)降低的程度。此外,还研究了PAD年轻女性HQOL的潜在决定因素,即传统心血管危险因素、狭窄部位和诊断后的时间。
这是一项基于人群的病例对照研究。研究对象为208名经血管造影诊断为PAD的年轻(<50岁)女性以及471名基于人群的年龄和性别匹配的对照受试者。所有参与者均完成了RAND-36问卷,该问卷可生成HQOL概况。问卷包含36个项目,用于评估HQOL的8个领域。每个领域的平均得分范围为0至100分,得分越高表明生活质量越好。
PAD对年轻女性的HQOL有有害影响。应对日常生活身体需求的能力受到影响,身体能力在很大程度上限制了活动。在“身体功能”和“身体角色”这两个领域观察到的平均差异分别为-25.1(95%置信区间[CI],-28.8,-21.4)和-22.5(95%CI,-28.9,-16.0)。在患有PAD的年轻女性群体中,HQOL并不取决于年龄、吸烟、高胆固醇血症或教育程度。然而,患有高血糖、高血压或体重指数增加的女性在RAND-36的1个或多个领域得分较低。狭窄部位也与HQOL有关;与狭窄部位更靠远端的女性相比,狭窄部位更靠近近端的患者在“身体功能”领域得分略高。诊断(1990 - 1999年)至填写RAND-36问卷(2000年)之间的时间(0 - 10年)与“心理健康”领域的得分有关;得分随时间增加。HQOL的其他7个领域的得分与疾病持续时间无显著关系。
与健康的年龄匹配对照受试者的HQOL相比,PAD年轻女性在RAND-36所有领域的生活质量在统计学上显著降低。近期诊断为PAD的患者的HQOL与数年前诊断的患者相当。有效的治疗可能会稳定(尽管不能改善)这一特定患者群体的生活质量。