Birmingham University, Department of Vascular Surgery, Heart of England NHS Trust, Birmingham, UK.
Eur J Vasc Endovasc Surg. 2012 Sep;44(3):341-4. doi: 10.1016/j.ejvs.2012.06.022. Epub 2012 Jul 23.
To determine the relationship between lower limb symptoms and generic health-related quality of life (HRQL) in patients with varicose veins (VV).
284 patients on the waiting list for VV treatment completed the Short Form-12 (SF12) and a questionnaire asking about the presence of lower limb symptoms commonly attributed to venous disease (pain or ache, itching, tingling, cramp, restless legs, a feeling of swelling, and heaviness).
Median age was 57 years (interquartile range 45-67); 100 (35%) were male, and 182 (64%) had CEAP clinical grade 2 or 3 disease. Jonckheere-Terpstra test for trend revealed that both physical (P < .0005) and mental (P = .001) HRQL worsened as the reported number of symptoms increased. Patients reporting tingling (P = .016, Mann-Whitney U test), cramp (P = .001), restless legs (P < .0005), swelling (P < .0005), and heaviness (P < .0005) had a significantly worse physical HRQL than those who did not. Mental HRQL was also significantly worse in patients with tingling (P = .010), cramp (P = .008), restless legs (P = .040), swelling (P = .001), and heaviness (P = .035). These significant relationships remained, and pain was also correlated with worse physical HRQL (P = .011), when linear regression was performed to control for CEAP clinical grade, age and sex.
Physical and mental HRQL is significantly worse in VV patients with lower limb symptoms irrespective of the clinical stage of disease. This observation confirms that VV are not primarily a cosmetic problem and that NHS rationing of treatment to those with CEAP C4-6 disease excludes many patients who would benefit from intervention in terms of HRQL. Generic HRQL instruments also allow comparison with interventions for other chronic conditions.
确定下肢症状与静脉曲张（VV）患者通用健康相关生活质量（HRQL）之间的关系。
284 名等待 VV 治疗的患者完成了 12 项简短表格（SF12）和一份问卷，询问下肢常见静脉疾病症状（疼痛或不适、瘙痒、刺痛、抽筋、不安腿、肿胀感和沉重感）的存在情况。
中位年龄为 57 岁（四分位间距 45-67）；100 名（35%）为男性，182 名（64%）患有 CEAP 临床 2 级或 3 级疾病。Jonckheere-Terpstra 趋势检验显示，随着报告症状数量的增加，身体（P<.0005）和精神（P=0.001）HRQL 均恶化。报告刺痛（P=0.016，Mann-Whitney U 检验）、抽筋（P=0.001）、不安腿（P<.0005）、肿胀（P<.0005）和沉重感（P<.0005）的患者比没有报告这些症状的患者身体 HRQL 更差。有刺痛（P=0.010）、抽筋（P=0.008）、不安腿（P=0.040）、肿胀（P=0.001）和沉重感（P=0.035）的患者精神 HRQL 也明显更差。当进行线性回归以控制 CEAP 临床分级、年龄和性别时，这些显著的关系仍然存在，并且疼痛也与更差的身体 HRQL 相关（P=0.011）。
无论疾病的临床阶段如何，下肢症状的 VV 患者的身体和精神 HRQL 明显更差。这一观察结果证实，VV 不仅仅是一个美容问题，NHS 将治疗限于 CEAP C4-6 疾病的患者排除了许多从 HRQL 干预中受益的患者。通用 HRQL 工具还允许与其他慢性疾病的干预措施进行比较。
