Simrén Magnus, Svedlund Jan, Posserud Iris, Björnsson Einar S, Abrahamsson Hasse
Department of Internal Medicine, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, S-41345 Göteborg, Sweden.
Clin Gastroenterol Hepatol. 2006 Feb;4(2):187-95. doi: 10.1016/s1542-3565(05)00981-x.
BACKGROUND & AIMS: Several gastrointestinal (GI) disorders have major effects on health-related quality of life (HRQOL), but there are few direct comparisons between functional GI disorders and organic GI diseases. This study aimed to compare HRQOL between these 2 groups and to assess factors of importance for HRQOL.
Three hundred ninety-nine consecutive patients attending a GI outpatient clinic completed HRQOL instruments (Short Form 36 [SF-36] and Psychological General Well-Being index [PGWB]) and the Gastrointestinal Symptom Rating Scale (GSRS). For the analyses we divided the patients into 2 diagnostic groups: functional GI disorders (n = 112) and organic GI diseases (n = 287).
Compared with norm values on SF-36 and PGWB, both patient groups exhibited profound reductions in HRQOL. After correcting for age, gender, and disease duration, patients with a functional GI disorder had significantly lower scores than patients with an organic GI disease on 6 of 8 SF-36 domains and 5 of 6 PGWB domains. Vitality and anxiety on PGWB, abdominal pain and diarrhea on GSRS, age, and gender independently contributed to the physical component score of SF-36 (adjusted R(2) = 32%). Patients with a functional GI disorder had more severe reflux, abdominal pain, constipation, and indigestion, but the severity of diarrhea did not differ between the groups. HRQOL was reduced with increasing severity of GI symptoms.
GI disorders have profound effects on HRQOL, and the impact is greater in patients with functional GI disorders as compared with organic GI diseases. The reduction in HRQOL is associated with the severity of both psychological and GI symptoms.
多种胃肠道（GI）疾病对健康相关生活质量（HRQOL）有重大影响，但功能性GI疾病与器质性GI疾病之间的直接比较较少。本研究旨在比较这两组患者的HRQOL，并评估对HRQOL重要的因素。
399名连续就诊于GI门诊的患者完成了HRQOL评估工具（简短健康调查问卷36项简表[SF-36]和心理总体幸福感指数[PGWB]）以及胃肠道症状评定量表（GSRS）。为进行分析，我们将患者分为两个诊断组：功能性GI疾病（n = 112）和器质性GI疾病（n = 287）。
与SF-36和PGWB的正常值相比，两组患者的HRQOL均显著降低。在校正年龄、性别和病程后，功能性GI疾病患者在SF-36的8个维度中的6个维度以及PGWB的6个维度中的5个维度上的得分显著低于器质性GI疾病患者。PGWB中的活力和焦虑、GSRS中的腹痛和腹泻、年龄以及性别独立地影响SF-36的身体成分得分（调整后R² = 32%）。功能性GI疾病患者有更严重的反流、腹痛、便秘和消化不良，但两组之间腹泻的严重程度没有差异。HRQOL随着GI症状严重程度的增加而降低。
GI疾病对HRQOL有深远影响，与器质性GI疾病相比，功能性GI疾病患者的影响更大。HRQOL的降低与心理和GI症状的严重程度均相关。
