脊髓功能障碍和肥胖对儿童及青少年健康相关生活质量的影响。
Impact of spinal cord dysfunction and obesity on the health-related quality of life of children and adolescents.
作者信息
Abresch Richard Ted, McDonald Dawn A, Widman Lana M, McGinnis Katrina, Hickey Kathryn J
机构信息
University of California Davis School of Medicine, Davis, California 95616, USA.
出版信息
J Spinal Cord Med. 2007;30 Suppl 1(Suppl 1):S112-8. doi: 10.1080/10790268.2007.11754614.
OBJECTIVES
The objectives of this study were: (1) to compare the health-related quality of life (HRQOL) of children and adolescents with mobility impairments due to spinal cord injury (SCI) and spina bifida (SB) to the HRQOL of children and adolescent controls without mobility impairments (CTRL); and (2) to examine the impact of of obesity on the HRQOL of these subjects.
METHODS
The Pediatric Quality of Life Inventory (PedsQL) was administered to 42 SB, 71 SCI and 60 able-bodied subjects who were 8-20 years of age. Subjects were categorized as obese if their BMI exceeded the 95th percentile for age. Twenty-one CTRL, 26 SB and 26 SCI subjects were obese.
RESULTS
The SCI and SB subjects had significantly lower subscores than the control subjects on the physical (p < 0.001), emotional (p < .01), social (p < .001), and school (p < .001) domains of the PedsQL. The obese (CTRL) group had lower subscores on the physical (p < 0.001), social (p < 0.001), and psychosocial (p < 0.001) domains of the PedsQL as compared to the non-obese CTRL group, while there were no significant differences in subscores from the emotional and school domains. In contrast to the subjects without mobility impairment, there were no significant differences between the sub-scores of the obese and non-obese subjects with spinal cord dysfunction secondary to SCI or SB. The mean total PedsQL score of the non-obese control group (87.7 +/- 2.1) was significantly higher than the obese control group (75.2 +/- 3.4, p < 0.02), which in turn was significantly higher than the SCI group (63.7 +/- 2.2, p < 0.02), and the SB group (63.0 +/- 2.2, p < 0.02).
CONCLUSION
Patients with SCI and SB have significantly lower HRQOL than children and adolescents without mobility impairments. Whereas obesity significantly reduces the quality of life scores of adolescents without mobility impairments, it has no significant incremental effect on subjects with SCI or SB.
目的
本研究的目的是：（1）比较因脊髓损伤（SCI）和脊柱裂（SB）导致行动不便的儿童和青少年与无行动不便的儿童和青少年对照组（CTRL）的健康相关生活质量（HRQOL）；（2）研究肥胖对这些受试者健康相关生活质量的影响。
方法
对42名8至20岁的脊柱裂患者、71名脊髓损伤患者和60名健全受试者进行了儿童生活质量量表（PedsQL）测试。如果受试者的体重指数（BMI）超过其年龄对应的第95百分位数，则被归类为肥胖。21名对照组、26名脊柱裂患者和26名脊髓损伤患者为肥胖者。
结果
在儿童生活质量量表的身体（p<0.001）、情感（p<0.01）、社会（p<0.001）和学校（p<0.001）领域，脊髓损伤和脊柱裂受试者的子分数显著低于对照组。与非肥胖对照组相比，肥胖（对照组）组在儿童生活质量量表的身体（p<0.001）、社会（p<0.001）和心理社会（p<0.001）领域的子分数较低，但在情感和学校领域的子分数没有显著差异。与无行动不便的受试者不同，继发于脊髓损伤或脊柱裂的脊髓功能障碍的肥胖和非肥胖受试者的子分数之间没有显著差异。非肥胖对照组的儿童生活质量量表总平均分（87.7±2.1）显著高于肥胖对照组（75.2±3.4，p<0.02），而肥胖对照组又显著高于脊髓损伤组（63.7±2.2，p<0.02）和脊柱裂组（63.0±2.2，p<0.02）。
结论
脊髓损伤和脊柱裂患者的健康相关生活质量显著低于无行动不便的儿童和青少年。肥胖显著降低了无行动不便青少年的生活质量得分，但对脊髓损伤或脊柱裂患者没有显著的额外影响。
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