Department of Pathophysiology, University of Leuven, Belgium.
Aliment Pharmacol Ther. 2011 Jan;33(2):261-74. doi: 10.1111/j.1365-2036.2010.04510.x. Epub 2010 Nov 17.
The influence of patient characteristics on HRQoL in functional dyspepsia is poorly understood.
To determine the contribution of gastric sensorimotor function, psychosocial factors & 'somatization' to HRQoL in functional dyspepsia.
In 259 tertiary care functional dyspepsia patients, we studied gastric sensorimotor function with barostat. We measured psychosocial factors and 'somatization' using self-report questionnaires. HRQoL was assessed using the SF-36 physical and mental composite scores (PCS, MCS). Bivariate associations between gastric sensorimotor function, psychosocial factors and 'somatization' on the one hand and PCS and MCS on the other were estimated. Variables significantly associated with PCS or MCS in bivariate analysis were entered into hierarchical multiple linear regression models.
Mean PCS was 40.1 ± 9.5; mean MCS was 45.1 ± 10.8. 'Somatization' (P < 0.0001) and chronic fatigue (P = 0.002) were significantly associated with impaired PCS (R² = 0.52, P < 0.0001). The effects of abuse history and depression were 'mediated' by 'somatization'. Trait anxiety (P = 0.02), alexithymia (P = 0.06), depression (P = 0.06), positive affect (P < 0.0001), negative affect (P = 0.002) and generalised anxiety disorder (P = 0.01) were significantly associated with impaired MCS (R² = 0.67, P < 0.0001).
'Somatization' is the most important risk factor for impaired physical HRQoL in functional dyspepsia; it 'mediates' the effect of abuse history and depression. Mental HRQoL is mainly explained by psychosocial factors.
患者特征对功能性消化不良患者健康相关生活质量（HRQoL）的影响尚不清楚。
确定胃感觉运动功能、心理社会因素和“躯体化”对功能性消化不良患者 HRQoL 的贡献。
在 259 例三级保健功能性消化不良患者中，我们使用胃测压仪研究胃感觉运动功能。我们使用自我报告问卷测量心理社会因素和“躯体化”。使用 SF-36 身体和精神综合评分（PCS、MCS）评估 HRQoL。一方面，胃感觉运动功能、心理社会因素和“躯体化”与 PCS 和 MCS 之间的双变量相关性，另一方面，与 PCS 或 MCS 呈显著相关的变量进行了分层多元线性回归模型分析。
平均 PCS 为 40.1±9.5；平均 MCS 为 45.1±10.8。“躯体化”（P＜0.0001）和慢性疲劳（P=0.002）与 PCS 受损显著相关（R²=0.52，P＜0.0001）。受虐待史和抑郁的影响通过“躯体化”“介导”。特质焦虑（P=0.02）、述情障碍（P=0.06）、抑郁（P=0.06）、积极情绪（P＜0.0001）、消极情绪（P=0.002）和广泛性焦虑障碍（P=0.01）与 MCS 受损显著相关（R²=0.67，P＜0.0001）。
“躯体化”是功能性消化不良患者身体 HRQoL 受损的最重要危险因素；它“介导”受虐待史和抑郁的影响。心理 HRQoL 主要由心理社会因素解释。
