Hudson Marie, Thombs Brett D, Steele Russell, Panopalis Pantelis, Newton Evan, Baron Murray
SMBD-Jewish General Hospital and McGill University, Montreal, Quebec, Canada.
Arthritis Rheum. 2009 Aug 15;61(8):1112-20. doi: 10.1002/art.24676.
A number of studies (all n <200) have assessed health-related quality of life (HRQOL) in patients with systemic sclerosis (SSc), but no systematic review of the effect of SSc on HRQOL has been done. The objective of this study was to systematically review the literature on HRQOL in SSc measured using the Medical Outcomes Trust Short Form 36 (SF-36).
A comprehensive search was conducted in August 2007 using Medline, CINAHL, and EMBase to identify original research studies reporting SF-36 scores of SSc patients. Selected studies were reviewed and characteristics of the study samples and SF-36 data were extracted. Bayesian meta-analysis and meta-regression were performed to obtain pooled estimates of SF-36 physical component summary (PCS) and mental component summary (MCS) scores for all patients as well as by limited and diffuse disease status.
Twelve data sets with a total of 1,127 SSc patients were included in the systematic review. HRQOL was impaired in patients with SSc, with pooled SF-36 PCS scores being more than 1 SD below the general population (38.3; 95% credible interval [95% CI] 35.2, 41.5) and pooled SF-36 MCS scores being approximately 0.5 SDs below the general population (46.6; 95% CI 44.2, 49.1). SF-36 PCS scores were 3.5 points (95% CI -1.0, 8.0) lower in patients with diffuse compared with limited disease.
This study provides robust evidence of the presence and magnitude of impairment in HRQOL in patients with SSc. Although the impairment appears greater in physical health, mental health impairment is also reported.
多项研究（样本量均n<200）评估了系统性硬化症（SSc）患者的健康相关生活质量（HRQOL），但尚未对SSc对HRQOL的影响进行系统评价。本研究的目的是系统评价使用医学结局信托简短健康调查36项问卷（SF-36）测量的SSc患者HRQOL的相关文献。
2007年8月利用医学数据库（Medline）、护理学与健康领域数据库（CINAHL）和荷兰医学文摘数据库（EMBase）进行全面检索，以识别报告SSc患者SF-36评分的原始研究。对入选研究进行综述，并提取研究样本特征和SF-36数据。进行贝叶斯荟萃分析和荟萃回归，以获得所有患者以及局限性和弥漫性疾病状态下SF-36身体成分汇总（PCS）和精神成分汇总（MCS）评分的合并估计值。
系统评价纳入了12个数据集，共1127例SSc患者。SSc患者的HRQOL受损，SF-36 PCS合并评分比一般人群低1个标准差以上（38.3；95%可信区间[95%CI]35.2，41.5），SF-36 MCS合并评分比一般人群低约0.5个标准差（46.6；95%CI 44.2，49.1）。与局限性疾病患者相比，弥漫性疾病患者的SF-36 PCS评分低3.5分（95%CI -1.0，8.0）。
本研究提供了有力证据证明SSc患者HRQOL受损的存在及其程度。虽然身体健康方面的损害似乎更大，但也有心理健康受损的报告。
