Bianchi G P, Zaccheroni V, Solaroli E, Vescini F, Cerutti R, Zoli M, Marchesini G
Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Università di Bologna, Italy.
Qual Life Res. 2004 Feb;13(1):45-54. doi: 10.1023/B:QURE.0000015315.35184.66.
Limited reports are available on quality of life (HRQL) in thyroid diseases, and no data are available in euthyroid disorders, such as goiter and Hashimoto thyroiditis. Also, asymptomatic patients may suffer a reduction in perceived health status due to distress related to physical appearance and awareness of disease. We measured HRQL by means of Medical Outcome Study Short Form-36 (SF-36) and Nottingham Health Profile (NHP) questionnaires in 368 patients (hypothyroid, 81; hyperthyroid, 45 (for both states including overt and subclinical states); Hashimoto thyroiditis, 51; euthyroid goiter, 191). The final scores of the domains were compared with age- and sex-adjusted Italian normative values, by computing the effect size. All domains of SF-36, except bodily pain, were reduced in thyroid disease; this was mainly the case of role limitation (both physical and emotional), general health and social functioning. The domains of NHP were less severely affected. HRQL was impaired also in the absence of altered hormone levels. Mood/behavior disturbances were present in a large proportion of patients and were significantly associated with poor HRQL. HRQL was significantly reduced in patients with thyroid diseases referred to a secondary level endocrinology unit. Perceived health status may be considered as an additional outcome of management and therapy of thyroid disorders.
关于甲状腺疾病患者的生活质量(HRQL)的报道有限,而对于甲状腺功能正常的疾病,如甲状腺肿和桥本甲状腺炎,尚无相关数据。此外,无症状患者可能因外观困扰和疾病意识而出现健康状况感知下降。我们通过医学结局研究简表36(SF - 36)和诺丁汉健康量表(NHP)问卷对368例患者进行了HRQL测量(甲状腺功能减退患者81例;甲状腺功能亢进患者45例(包括显性和亚临床状态);桥本甲状腺炎患者51例;甲状腺功能正常的甲状腺肿患者191例)。通过计算效应量,将各领域的最终得分与年龄和性别调整后的意大利标准值进行比较。除身体疼痛外,SF - 36的所有领域在甲状腺疾病中均有所降低;主要是角色限制(身体和情感方面)、总体健康和社会功能领域。NHP的领域受影响程度较轻。在激素水平未改变的情况下,HRQL也受到损害。很大一部分患者存在情绪/行为障碍,且与不良的HRQL显著相关。转诊至二级内分泌科的甲状腺疾病患者的HRQL显著降低。健康状况感知可被视为甲状腺疾病管理和治疗的一项额外结局。