Academic Vascular Surgical Unit, University of Hull and Hull York Medical School, Hull, UK.
Br J Surg. 2011 Aug;98(8):1089-98. doi: 10.1002/bjs.7500. Epub 2011 May 20.
A clear understanding of the relationship between venous reflux, clinical venous disease and the effects on quality of life (QoL) remains elusive. This study aimed to explore the impact of venous disease, and assess any incremental direct effect of progressive disease on health-related QoL, with the ultimate aim to model venous morbidity.
Consecutive patients with venous disease were assessed for inclusion in the study. Patients with isolated, unilateral, single superficial axial incompetence diagnosed on duplex imaging were included. Clinical grading was performed with the Clinical Etiologic Anatomic Pathophysiologic (CEAP) classification and Venous Clinical Severity Score (VCSS). Patients completed generic (Short Form 36, SF-36(®); EuroQol 5D, EQ-5D(™)) and disease-specific (Aberdeen Varicose Vein Questionnaire, AVVQ) QoL instruments. Multivariable regression modelling was performed, taking account of demographic and anatomical factors, to explore the effect of clinical severity on QoL impairment.
Some 456 patients with C2-6 venous disease were included, along with control data for 105 people with C0-1 disease. Increasing clinical grade corresponded strongly with deterioration in disease-specific QoL (P < 0.001). This could be stratified into three distinguishable groups: C0-1, C2-4 and C5-6 (P < 0.001 to P = 0.006). Increasing clinical grade also corresponded with deterioration in the physical domains of SF-36(®) (P < 0.001 to P = 0.016), along with EQ-5D(™) index utility (quality-adjusted life year) scores (P < 0.001).
Demonstrable morbidity was seen, even with uncomplicated venous disease. The physical impairment seen with venous ulceration was comparable with that seen in congestive cardiac failure and chronic lung disease.
目前对于静脉反流、临床静脉疾病与生活质量（QoL）之间的关系仍认识不清。本研究旨在探讨静脉疾病的影响，并评估疾病进展对健康相关 QoL 的直接影响，最终目的是对静脉疾病的发病情况进行建模。
对静脉疾病患者进行连续评估以确定是否符合入组标准。本研究纳入了经双功能超声检查诊断为单侧、孤立、单一浅静脉轴向功能不全的患者。采用临床病因解剖病理生理学（CEAP）分类和静脉临床严重程度评分（VCSS）对患者进行临床分级。患者完成了一般健康调查问卷（36 项简短健康调查问卷，SF-36(®)；欧洲五维健康量表，EQ-5D(™)）和疾病特异性调查问卷（阿伯丁静脉曲张问卷，AVVQ）。多变量回归模型分析考虑了人口统计学和解剖学因素，以探究临床严重程度对 QoL 损害的影响。
共纳入了 456 例 C2-6 级静脉疾病患者和 105 例 C0-1 级静脉疾病对照者。临床分级的增加与疾病特异性 QoL 的恶化显著相关（P < 0.001）。可将其分为三组：C0-1、C2-4 和 C5-6 级（P < 0.001 至 P = 0.006）。临床分级的增加还与 SF-36(®)（P < 0.001 至 P = 0.016）的身体领域恶化以及 EQ-5D(™)指数效用（质量调整生命年）评分（P < 0.001）恶化相关。
即使是单纯的静脉疾病也可观察到明显的发病情况。静脉溃疡患者的身体损伤与充血性心力衰竭和慢性肺病患者的损伤相当。
