肢端肥大症生活质量问卷（AcroQoL）的有效性及临床适用性：一项为期6个月的前瞻性研究

Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study.

作者信息

Webb Susan M, Badia Xavier, Surinach Nuria Lara

机构信息

Department of Endocrinology, Hospital Sant Pau, Autonomous University of Barcelona, Spain.

出版信息

Eur J Endocrinol. 2006 Aug;155(2):269-77. doi: 10.1530/eje.1.02214.

DOI:10.1530/eje.1.02214

PMID:16868140

Abstract

OBJECTIVE

Validate the acromegaly quality of life (AcroQoL) questionnaire as a disease-generated questionnaire, which analyses physical and psychological domains, the latter subdivided into appearance and personal relationship sub-scales, to evaluate health-related quality of life (HRQoL) in acromegaly.

DESIGN

Prospective, observational multicenter study.

METHODS

One hundred and six patients with acromegaly, 42 with active disease studied basally and 6 months after treatment ('sensitivity to change' group), and 64 with treated, stable disease, studied twice within 1 month ('reliability' group) were included. As controls, a reference Spanish population (n=12,245 for the EuroQoL questionnaire) and 157 obese patients (body mass index>30 kg/m2) were studied basally. Socio-demographic data, clinical activity, co-morbidity, GH, IGF-I, and HRQoL (overall perception of health state, EuroQoL and AcroQoL in the obese controls and acromegalic patients) were evaluated.

RESULTS

Globally, AcroQoL scored worse in the 'sensitivity to change' group than in the 'reliability' group (56+/-20 vs 65+/-18, P<0.05), but did not discriminate between patients and obese controls. The psychological domain was worse in the 'sensitivity to change' group than obese controls (P<0.05). Appearance was the most affected sub-scale in acromegaly and significantly worse than in obese controls. The sub-scale personal relationships of AcroQoL were less affected in the 'reliability' group than in obese controls (P<0.05). Patients with acromegaly and obese controls showed more problems on the EuroQoL than general Spanish population. Significant correlations were observed globally and for each dimension between AcroQoL and the generic questionnaires. On re-testing, no change was observed in the 'reliability' group in any questionnaire, demonstrating good test-re-test reliability. In the 'sensitivity to change' group after 6 months of treatment, there was improvement in the generic questionnaires and in AcroQoL score (P<0.01). Internal consistency of AcroQoL was good (Cronbach's alpha>0.7). No correlation between AcroQoL and GH or IGF-I was observed.

CONCLUSION

AcroQoL questionnaire is a valid tool for the assessment of HRQoL in clinical practice in patients with acromegaly.

摘要

目的

验证肢端肥大症生活质量（AcroQoL）问卷作为一种疾病特异性问卷的有效性，该问卷分析身体和心理领域，后者又细分为外貌和人际关系子量表，以评估肢端肥大症患者的健康相关生活质量（HRQoL）。

设计

前瞻性观察性多中心研究。

方法

纳入106例肢端肥大症患者，其中42例患有活动性疾病，在基线时和治疗后6个月进行研究（“变化敏感性”组），64例患有已治疗的稳定疾病患者，在1个月内进行两次研究（“可靠性”组）。作为对照，对一个西班牙参考人群（欧洲生活质量调查问卷的n = 12245）和157例肥胖患者（体重指数>30 kg/m²）进行基线研究。评估社会人口统计学数据、临床活动、合并症、生长激素（GH）、胰岛素样生长因子-I（IGF-I）和HRQoL（肥胖对照组和肢端肥大症患者对健康状态的总体感知、欧洲生活质量调查问卷和AcroQoL）。

结果

总体而言，“变化敏感性”组的AcroQoL评分比“可靠性”组差（56±20 vs 65±18，P<0.05），但在患者和肥胖对照组之间没有区分能力。“变化敏感性”组的心理领域比肥胖对照组差（P<0.05）。外貌是肢端肥大症中受影响最大的子量表，明显比肥胖对照组差。AcroQoL的人际关系子量表在“可靠性”组中比肥胖对照组受影响小（P<0.05）。肢端肥大症患者和肥胖对照组在欧洲生活质量调查问卷上比西班牙普通人群有更多问题。在AcroQoL与通用问卷之间，在总体和每个维度上都观察到显著相关性。重新测试时，“可靠性”组中任何问卷均未观察到变化，表明测试-重测信度良好。在“变化敏感性”组治疗6个月后，通用问卷和AcroQoL评分有所改善（P<0.01）。AcroQoL的内部一致性良好（Cronbach's α>0.7）。未观察到AcroQoL与GH或IGF-I之间的相关性。