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特应性皮炎患儿的生活质量与疾病严重程度相关。

Quality of life and disease severity are correlated in children with atopic dermatitis.

作者信息

Ben-Gashir M A, Seed P T, Hay R J

机构信息

St John's Institute of Dermatology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK.

出版信息

Br J Dermatol. 2004 Feb;150(2):284-90. doi: 10.1111/j.1365-2133.2004.05776.x.

Abstract

BACKGROUND

Atopic dermatitis (AD) in children may affect their daily activities and normal development. It can have a negative impact on the child's behaviour. Little is known about the quality of life (QOL) in children and its relationship to disease severity, especially from a community-based study.

OBJECTIVES

To document the impact of AD on children's QOL and its relationship to disease severity.

METHODS

The targeted population, before recruitment, comprised children with AD aged 5-10 years from a primary care setting. Their general practitioners identified potential patients and the U.K. diagnostic criteria for AD were used to verify the diagnosis. Eczema severity was assessed using the SCORAD (SCORing Atopic Dermatitis) index. The Children's Dermatology Life Quality Index (CDLQI) was used to quantify the impact of AD on children's QOL. These two parameters were evaluated on two occasions 6 months apart. The Spearman correlation coefficient and multiple regressions were used in statistical analysis.

RESULTS

Of the 116 children attending the first QOL assessment visit, 78 (mean age 8.6 years, 44 girls and 34 boys) were able to complete the CDLQI. Of these 78 children, 71 (91%) attended the second visit, and were included in the analysis. The children's QOL was affected in 65 (92%) and 55 (77%) children attending the first and second visits, respectively. The CDLQI was significantly correlated with the SCORAD at the first and second visits (r=0.52, P<0.001 and r=0.59, P<0.001, respectively). Each unit change in the SCORAD was associated with a 0.12 (95% confidence interval 0.04-0.19, P=0.004) unit change in the children's QOL.

CONCLUSIONS

We have shown a positive correlation between children's QOL and disease severity on cross-sectional and over time observation. This highlights the impact of AD on children's life. It also draws attention to the long-term effect on children's behaviour and development. In addition, these findings may imply that the CDLQI could be used as an extra measure of disease assessment in clinical practice and research studies.

摘要

背景

儿童特应性皮炎(AD)可能会影响其日常活动和正常发育,还会对儿童的行为产生负面影响。关于儿童的生活质量(QOL)及其与疾病严重程度的关系,尤其是基于社区研究的了解甚少。

目的

记录AD对儿童生活质量的影响及其与疾病严重程度的关系。

方法

在招募前,目标人群包括来自初级保健机构的5至10岁AD患儿。他们的全科医生识别潜在患者,并使用英国AD诊断标准进行确诊。采用特应性皮炎评分(SCORAD)指数评估湿疹严重程度。使用儿童皮肤病生活质量指数(CDLQI)量化AD对儿童生活质量的影响。这两个参数在相隔6个月的两个时间点进行评估。统计分析采用Spearman相关系数和多元回归。

结果

在首次生活质量评估访视的116名儿童中,78名(平均年龄8.6岁,44名女孩和34名男孩)能够完成CDLQI。在这78名儿童中,71名(91%)参加了第二次访视并纳入分析。在首次和第二次访视的儿童中,分别有65名(92%)和55名(77%)儿童的生活质量受到影响。首次和第二次访视时,CDLQI与SCORAD均显著相关(r分别为0.52,P<0.001和r为0.59,P<0.001)。SCORAD每变化一个单位,儿童生活质量相应变化0.12(95%置信区间0.04 - 0.19,P = 0.004)个单位。

结论

我们通过横断面和长期观察表明,儿童生活质量与疾病严重程度呈正相关。这突出了AD对儿童生活的影响,也引起了对其对儿童行为和发育长期影响的关注。此外,这些发现可能意味着CDLQI可作为临床实践和研究中疾病评估的额外指标。

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