Kuriyama Motoaki, Kato Jun, Kuwaki Kenji, Morimoto Naofumi, Nawa Toru, Fujimoto Tsuyoshi, Kono Hiroyuki, Okano Nobuaki, Miyaike Jiro, Morita Takechiyo, Okada Hiroyuki, Suzuki Seiyuu, Yoshioka Toshifumi, Shiode Junji, Suwaki Kinichiro, Sakaguchi Kohsaku, Shiratori Yasushi
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
Eur J Gastroenterol Hepatol. 2008 Jul;20(7):634-41. doi: 10.1097/MEG.0b013e3282f5e9c9.
The health-related quality of life (HRQOL) of patients with ulcerative colitis (UC) can be impaired because of the chronic symptoms. Although UC patients suffer from such symptoms over the long term, there have been few reports on the changes of HRQOL with disease duration. The aim of this study was to clarify these changes.
The HRQOL of 331 Japanese UC patients was examined using the validated Japanese version of the Inflammatory Bowel Disease Questionnaire (J-IBDQ). HRQOL and factors affecting HRQOL identified using multiple linear regression analysis were stratified by disease duration.
Of the 15 clinical factors examined, the clinical activity index score was the strongest determinant (P<0.0001) of all the scores of IBDQ regardless of disease duration. HRQOL did not differ significantly among patients with different disease durations. The factors, however, that affected HRQOL varied according to disease duration. In patients with disease duration of less than 5 years, the clinical activity index score was the predominant factor affecting HRQOL. Being 'on sick leave or hospitalized' was a significant factor impairing HRQOL in patients with disease duration of 5-9 years. Moreover, complications due to corticosteroids significantly impaired all of the IBDQ scores in patients with disease duration of 10 years or more.
Factors that affected the HRQOL of UC patients varied according to the patients' disease duration. Our findings should assist in the development of a long-term strategy for the treatment of UC patients.
溃疡性结肠炎(UC)患者的健康相关生活质量(HRQOL)可能因慢性症状而受损。尽管UC患者长期遭受此类症状困扰,但关于HRQOL随病程变化的报道较少。本研究的目的是阐明这些变化。
使用经过验证的日语版炎症性肠病问卷(J-IBDQ)对331名日本UC患者的HRQOL进行评估。通过多元线性回归分析确定的HRQOL及影响HRQOL的因素按病程进行分层。
在所检查的15项临床因素中,无论病程长短,临床活动指数评分都是IBDQ所有评分的最强决定因素(P<0.0001)。不同病程患者的HRQOL无显著差异。然而,影响HRQOL的因素因病程而异。病程小于5年的患者中,临床活动指数评分是影响HRQOL的主要因素。“病假或住院”是病程为5 - 9年患者中损害HRQOL的一个重要因素。此外,病程10年及以上患者中,皮质类固醇引起的并发症显著损害了所有IBDQ评分。
影响UC患者HRQOL的因素因患者病程而异。我们的研究结果应有助于制定UC患者的长期治疗策略。