Hirsch Jan D, Terkeltaub Robert, Khanna Dinesh, Singh Jasvinder, Sarkin Andrew, Shieh Micki, Kavanaugh Arthur, Lee Susan J
Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.
Patient Relat Outcome Meas. 2010 Mar 1;2010:1-8. doi: 10.2147/PROM.S8310.
Assess the association of gout characteristics with health-related quality of life (HRQoL) using a new gout-specific HRQoL instrument, the Gout Impact Scale (GIS). PATIENTS AND METHODS: Gout patients completed the GIS (five scales [0-100 score each] representing impact of gout overall [three scales] and during an attack [two scales]) and other questions describing recent gout attacks, treatment, gout history, comorbidities, and demographics. Physicians confirmed gout diagnosis, presence of tophi, and most recent serum uric acid (sUA) level. Relationships between gout characteristics and GIS scores were examined using analysis of variance and correlation analyses. RESULTS: The majority of patients were male (90.2%) with a mean age of 62.2 (±11.8) years. Approximately one-half (49.7%) reported ≥3 gout attacks in the past year and the majority (57.9%) reported experiencing gout-related pain between attacks. Patients had appreciable concern about their gout ("gout concern overall" scale, 63.1 ± 28.0) but believed their treatment was adequate ("unmet gout treatment need" scale (38.2 ± 21.4) below scale mid-point). Significantly worse GIS scores were associated with increasing attack frequency and greater amount of time with pain between attacks (most scales, P < 0.001). Common objective measures such as sUA level, presence of tophi and the number of joints involved in a typical attack did not appear to be good indicators of the impact of gout on the patients' HRQoL. CONCLUSION: Attack frequency and gout pain between attacks were important correlates of patients' ratings of gout impact on their HRQoL. Further studies are needed to determine the minimal important difference for each GIS scale and interpret our results relative to other patient populations with gout.
使用一种新的痛风特异性健康相关生活质量（HRQoL）工具——痛风影响量表（GIS），评估痛风特征与健康相关生活质量之间的关联。
痛风患者完成了GIS（五个量表[每个量表0 - 100分]，分别代表痛风总体影响[三个量表]和发作期间的影响[两个量表]）以及其他描述近期痛风发作、治疗、痛风病史、合并症和人口统计学特征的问题。医生确认痛风诊断、痛风石的存在以及最近的血清尿酸（sUA）水平。使用方差分析和相关分析来检验痛风特征与GIS评分之间的关系。
大多数患者为男性（90.2%），平均年龄为62.2（±11.8）岁。约一半（49.7%）的患者报告在过去一年中有≥3次痛风发作，大多数（57.9%）的患者报告在发作间期经历过痛风相关疼痛。患者对自己的痛风有相当程度的担忧（“总体痛风担忧”量表评分为63.1±28.0），但认为他们的治疗是充分的（“未满足的痛风治疗需求”量表评分为38.2±21.4，低于量表中点）。GIS评分显著更差与发作频率增加以及发作间期疼痛时间延长相关（大多数量表，P<0.001）。常见的客观指标如sUA水平、痛风石的存在以及典型发作中受累关节的数量，似乎并不是痛风对患者HRQoL影响的良好指标。
发作频率和发作间期的痛风疼痛是患者对痛风对其HRQoL影响评分的重要相关因素。需要进一步研究以确定每个GIS量表的最小重要差异，并相对于其他痛风患者群体来解释我们的结果。
