Jahelka Barbara, Dorner Thomas, Terkula Robert, Quittan Michael, Bröll Hans, Erlacher Ludwig
Department of Rheumatology, Sozialmedizinisches Zentrum Süd - Kaiser-Franz-Josef-Spital mit Gottfried von Preyer'schem Kinderspital, Vienna, Austria.
Wien Med Wochenschr. 2009 May;159(9-10):235-40. doi: 10.1007/s10354-009-0655-y.
Health-related quality of life (HRQOL) is an important aspect in the management of patients with osteoporosis. The objective of this study was to estimate differences in HRQOL in women and men with osteopenia and osteoporosis with and without a fracture history and to assess HRQOL with a generic and disease-specific instrument.
Women and men were recruited from a geriatric rehabilitation department. Osteopenia or osteoporosis was diagnosed by Dual X-Ray Energy Absorptiometry (DXA). HRQOL was evaluated with the generic SF-36 questionnaire and the quality of life questionnaire of the International Osteoporosis Foundation (QUALEFFO-41). All subjects were instructed to complete these questionnaires. The level of pain was documented with a VAS (Visual Analogue Scale).
173 women and 49 men at a mean age of 79.3 +/- 8.5 years were enrolled. 85 participants reported a history of vertebral or hip fractures. The QUALEFFO score was 49.8 +/- 19.2 in patients with osteopenia, but significantly higher in osteoporotic patients without fractures (mean 58.1 +/- 13.3; p < 0.05). In osteoporotic patients with a fracture history the mean QUALEFFO score was significantly higher still, i.e. 63.8 +/- 13.6 (p < 0.05). The mean SF-36 summation scores of osteopenic patients and osteoporotic patients without fractures were similar (314 +/- 117 and 312 +/- 99, respectively). Osteoporotic patients with a fracture history showed lower mean scores (276 +/- 88; p < 0.05). VAS scores did not differ significantly.
Osteoporosis has a considerably greater impact on HRQOL than osteopenia. Patients with a history of vertebral or hip fractures have a significantly poorer quality of life. These differences should be taken into account when prioritizing health care management.
健康相关生活质量（HRQOL）是骨质疏松症患者管理中的一个重要方面。本研究的目的是评估有和没有骨折病史的骨质减少和骨质疏松的女性和男性在HRQOL方面的差异，并使用通用和疾病特异性工具评估HRQOL。
从老年康复科招募女性和男性。通过双能X线吸收法（DXA）诊断骨质减少或骨质疏松。使用通用的SF-36问卷和国际骨质疏松基金会的生活质量问卷（QUALEFFO-41）评估HRQOL。所有受试者均被要求完成这些问卷。使用视觉模拟量表（VAS）记录疼痛程度。
共纳入173名女性和49名男性，平均年龄为79.3±8.5岁。85名参与者报告有椎体或髋部骨折病史。骨质减少患者的QUALEFFO评分为49.8±19.2，但无骨折的骨质疏松患者评分显著更高（平均58.1±13.3；p<0.05）。有骨折病史的骨质疏松患者的平均QUALEFFO评分更高，即63.8±13.6（p<0.05）。骨质减少患者和无骨折的骨质疏松患者的平均SF-36总分相似（分别为314±117和312±99）。有骨折病史的骨质疏松患者的平均评分较低（276±88；p<0.05）。VAS评分无显著差异。
骨质疏松症对HRQOL的影响比骨质减少大得多。有椎体或髋部骨折病史的患者生活质量明显较差。在确定医疗保健管理的优先顺序时应考虑这些差异。
