Department of Dermatology, Venereology and Allergology, University of Medicine, Wroclaw, Poland.
Acta Derm Venereol. 2011 May;91(3):313-7. doi: 10.2340/00015555-1075.
A total of 334 end-stage renal disease patients with moderate-to-severe uraemic xerosis were surveyed for quality of life assessment, using the generic Short-Form (SF-12) scale and the Dermatology Life Quality Index (DLQI). In parallel, the intensity of xerosis at four sites (the two lower legs, chest, forearm without arterio-venous shunt) was assessed, using a five-point lesional intensity score. Pruritus was auto-assessed by the patients, using a 100-mm visual analogue scale. Uraemic xerosis patients had a marked deterioration in the Physical Component Summary of SF-12 (mean ± SD: 34.92 ± 9.98) and DLQI (5.06 ± 4.73). Younger age (r = -0.20), xerosis intensity (r = 0.14), and the presence of pruritus (p < 0.0001) and its intensity (r = 0.50) were shown to be significant worsening factors of DLQI. Because a low, but significant, correlation between the intensity of xerosis and pruritus was also demonstrated (r = 0.18), the direct contribution of age, xerosis and pruritus on DLQI was analysed in a multiple linear regression model. Age and pruritus intensity, but not xerosis intensity, were found to be independent contributors to DLQI deterioration (p < 0.0005). On the other hand, uraemic xerosis without associated pruritus still resulted in DLQI alteration (3.24 ± 3.99). It was concluded that young age and intensity of uraemic pruritus compromise quality of life in uraemic xerosis patients. Some characteristics of uraemic xerosis other than xerosis intensity may also be involved in quality of life alteration.
共有 334 名患有中重度尿毒症性皮肤干燥症的终末期肾病患者接受了生活质量评估,使用了通用简式健康调查问卷 (SF-12) 量表和皮肤病生活质量指数 (DLQI)。同时,还使用 5 分制皮损严重程度评分评估了四个部位(双小腿、胸部、无动静脉分流的前臂)的干燥程度。瘙痒由患者通过 100mm 视觉模拟量表进行自我评估。尿毒症性皮肤干燥症患者的 SF-12 量表的生理成分综合评分(平均值±标准差:34.92±9.98)和 DLQI(5.06±4.73)明显恶化。年龄较小(r=-0.20)、干燥程度(r=0.14)、瘙痒存在(p<0.0001)及其严重程度(r=0.50)均为 DLQI 恶化的显著因素。由于还显示了干燥症严重程度和瘙痒之间存在低度但显著的相关性(r=0.18),因此在多元线性回归模型中分析了年龄、干燥症和瘙痒对 DLQI 的直接影响。发现年龄和瘙痒严重程度,但不是干燥症严重程度,是 DLQI 恶化的独立影响因素(p<0.0005)。另一方面,无瘙痒的尿毒症性皮肤干燥症仍会导致 DLQI 改变(3.24±3.99)。研究得出结论,年轻和尿毒症性瘙痒的严重程度会影响尿毒症性皮肤干燥症患者的生活质量。除了干燥症严重程度之外,尿毒症性皮肤干燥症的某些特征可能也会影响生活质量的改变。