Halder S L S, Locke G R, Talley N J, Fett S L, Zinsmeister A R, Melton L J
Division of Gastroenterology and Internal Medicine Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
Aliment Pharmacol Ther. 2004 Jan 15;19(2):233-42. doi: 10.1111/j.0269-2813.2004.01807.x.
The health-related quality of life is impaired in patients with functional gastrointestinal disorders seen in referral centres.
To determine whether the health-related quality of life is impaired in subjects with functional disorders in the community and whether any differences can be explained by psychological co-morbidity.
In a population-based, nested, case-control study, subjects reporting symptoms of either dyspepsia or irritable bowel syndrome and healthy controls were interviewed and completed a battery of psychological measures plus a validated, generic, health-related quality of life measure (Medical Outcomes Study 36-item short form health survey, SF-36). The association between irritable bowel syndrome and dyspepsia and the physical and mental composite scores of SF-36 were assessed with and without adjustment for psychological state.
One hundred and twelve cases (30 dyspepsia, 39 irritable bowel syndrome, 32 dyspepsia and irritable bowel syndrome and 11 gastrointestinal symptoms but not dyspepsia or irritable bowel syndrome) and 110 controls were enrolled. In the unadjusted linear regression models, irritable bowel syndrome (but not dyspepsia) was negatively associated with the physical composite score (P < 0.05); in an adjusted model, the association between the physical health-related quality of life and irritable bowel syndrome was explained by the Symptom Checklist-90 somatization score alone. In unadjusted models, irritable bowel syndrome and dyspepsia were each negatively associated with the mental composite score (P < 0.05). The association between the mental health-related quality of life and dyspepsia remained after adjusting for psychological covariates, but the association between this and irritable bowel syndrome was not significant after adjustment.
In the community, health-related quality of life is impaired in subjects with irritable bowel syndrome and dyspepsia; however, much of this association can be explained by psychological factors.
在转诊中心就诊的功能性胃肠病患者的健康相关生活质量受损。
确定社区中功能性疾病患者的健康相关生活质量是否受损，以及心理共病能否解释其中的差异。
在一项基于人群的巢式病例对照研究中，对报告有消化不良或肠易激综合征症状的受试者及健康对照进行访谈，并完成一系列心理测量以及一项经过验证的、通用的、与健康相关的生活质量测量（医学结局研究36项简短健康调查，SF - 36）。在调整和未调整心理状态的情况下，评估肠易激综合征和消化不良与SF - 36的身体和心理综合评分之间的关联。
共纳入112例病例（30例消化不良、39例肠易激综合征、32例既有消化不良又有肠易激综合征以及11例有胃肠道症状但无消化不良或肠易激综合征）和110例对照。在未调整的线性回归模型中，肠易激综合征（而非消化不良）与身体综合评分呈负相关（P < 0.05）；在调整模型中，仅症状自评量表90项躯体化评分就能解释与健康相关的身体生活质量和肠易激综合征之间的关联。在未调整模型中，肠易激综合征和消化不良均与心理综合评分呈负相关（P < 0.05）。调整心理协变量后，与健康相关的心理健康生活质量与消化不良之间的关联仍然存在，但调整后与肠易激综合征之间的关联不显著。
在社区中，肠易激综合征和消化不良患者的健康相关生活质量受损；然而，这种关联很大程度上可由心理因素解释。
