Regensteiner Judith G, Hiatt William R, Coll Joseph R, Criqui Michael H, Treat-Jacobson Diane, McDermott Mary M, Hirsch Alan T
Department of Medicine, University of Colorado School of Medicine, Denver, CO 80262, USA.
Vasc Med. 2008 Feb;13(1):15-24. doi: 10.1177/1358863X07084911.
This study tested the hypothesis that patients with PAD have impaired health-related quality of life (HRQoL) to a degree similar to that of patients with other types of cardiovascular disease (other-CVD), and also evaluated the clinical features of PAD associated with impaired HRQoL. This was a cross-sectional study in 350 primary care practice sites nationwide with 6,499 participants. The reference group had no clinical or hemodynamic evidence of PAD or other-CVD; the PAD group had an ankle-brachial index < 0.90 or a prior history of PAD; the other-CVD group had a clinical history of cardiac or cerebral vascular disease (but no PAD), and the combined PAD-other-CVD group included both diagnoses. Individuals were assessed using four HRQoL questionnaires including the Walking Impairment Questionnaire (WIQ), Medical Outcomes Study SF-36 (SF-36), Cantril Ladder of Life and the PAD Quality of Life questionnaire. PAD patients had lower WIQ distance scores than the other-CVD group. Both the PAD and other-CVD groups had significantly lower SF-36 Physical Function scores compared with the reference group. The WIQ revealed that PAD patients were more limited by calf pain, whereas other-CVD patients were more limited by chest pain, shortness of breath and palpitations. In conclusion, in this nationwide study, one of the first to directly compare the HRQoL burden of CVD with that of PAD, the evaluation of PAD in office practice revealed a HRQoL burden as great in magnitude as in patients with other forms of CVD.
外周动脉疾病(PAD)患者的健康相关生活质量(HRQoL)受损程度与其他类型心血管疾病(other-CVD)患者相似,并评估了与HRQoL受损相关的PAD临床特征。这是一项在全国350个初级保健机构开展的横断面研究,共有6499名参与者。参照组无PAD或other-CVD的临床或血流动力学证据;PAD组踝臂指数<0.90或有PAD既往史;other-CVD组有心脏或脑血管疾病临床病史(但无PAD),PAD-other-CVD合并组包括两种诊断。使用四份HRQoL问卷对个体进行评估,包括步行障碍问卷(WIQ)、医学结局研究简明健康调查(SF-36)、坎特里尔生活阶梯量表和PAD生活质量问卷。PAD患者的WIQ距离得分低于other-CVD组。与参照组相比,PAD组和other-CVD组的SF-36身体功能得分均显著更低。WIQ显示,PAD患者受小腿疼痛限制更大,而other-CVD患者受胸痛、呼吸急促和心悸限制更大。总之,在这项全国性研究中,作为首批直接比较CVD与PAD的HRQoL负担的研究之一,门诊实践中对PAD的评估显示其HRQoL负担与其他形式CVD患者的负担程度相当。