中重度银屑病患者的人口统计学特征及健康相关生活质量：VACAP研究
Demographic characteristics and health-related quality of life of patients with moderate-to-severe psoriasis: The VACAP study.
作者信息
Daudén E, Pujol R M, Sánchez-Carazo J L, Toribio J, Vanaclocha F, Puig L, Yébenes M, Sabater E, Casado M A, Caloto M T, Aragón B
机构信息
Hospital La Princesa, Madrid, Spain.
出版信息
Actas Dermosifiliogr. 2013 Nov;104(9):807-14. doi: 10.1016/j.ad.2013.03.005. Epub 2013 Jul 1.
BACKGROUND
Psoriasis is associated with a deterioration in the health-related quality of life (HRQoL) of affected patients. The aim of this study was to assess the HRQoL of patients with moderate-to-severe psoriasis.
METHODS
A prospective observational study (the VACAP Study) was carried out in 123 centers in Spain with 1217 patients. Patients were evaluated at baseline (visit 1 [V1]) and again four months later (visit 2 [V2]). The severity of psoriasis was determined using the following indices: (i) Psoriasis Area and Severity Index (PASI) (score range 0-72, higher score indicates more severe disease), (ii) the body surface area (BSA) affected, and (iii) the Physicians Global Assessment (PGA) (range 1-7, higher score indicates more severe disease). Four questionnaires were used for the assessment of the HRQoL: (i) the Short-Form 36 quality-of-life questionnaire (SF-36) (score range 0-100, higher score indicates better HRQoL); (ii) Euroqol (EQ-5D) (range from 1 to 3, lower score indicates better HRQoL); (iii) Dermatology Life Quality Index (DLQI) (ranges 0-30; from best to worst HRQoL); and (iv) Psoriasis Disability Index (PDI) (ranges 0-45; higher score indicates better HRQoL).
RESULTS
The mean (SD) age of the patients was 45.11 (13.92) years at V1. The mean age at the onset of psoriasis was 26.08 (14.19) years. The majority of patients were female (61%) and were employed (68%). The mean PASI score was 13.24 (9.50) at V1 and 5.07 (6.03) at V2 (P<.001). Scores from the generic HRQoL questionnaires (EQ-5D, SF-36) showed significant improvement between visits in all dimensions measured (P<.001). The disease-specific questionnaires also revealed overall improvements in quality of life over time: the DLQI mean total score was 8.97 (7.28) at V1 and 4.76 (5.72) at V2 (P<.001), and the PDI mean total score was 9.24 (8.76) V1 and 4.88 (6.65) at V2 (P<.001). Multivariate analysis using PDI as the dependent variable showed that the principal factors related to HRQoL were severity of psoriasis as measured by PASI (P<.001), and gender (P=.048).
CONCLUSIONS
The principal factor related to HRQoL in patients with psoriasis is the severity of the disease.
背景
银屑病与受累患者健康相关生活质量（HRQoL）的恶化有关。本研究的目的是评估中度至重度银屑病患者的HRQoL。
方法
在西班牙的123个中心对1217例患者进行了一项前瞻性观察研究（VACAP研究）。在基线时（第1次就诊[V1]）对患者进行评估，并在4个月后再次评估（第2次就诊[V2]）。使用以下指标确定银屑病的严重程度：（i）银屑病面积和严重程度指数（PASI）（评分范围0 - 72，分数越高表明疾病越严重），（ii）受累的体表面积（BSA），以及（iii）医生整体评估（PGA）（范围1 - 7，分数越高表明疾病越严重）。使用四份问卷评估HRQoL：（i）简明健康状况调查问卷（SF - 36）（评分范围0 - 100，分数越高表明HRQoL越好）；（ii）欧洲五维度健康量表（EQ - 5D）（范围从1到3，分数越低表明HRQoL越好）；（iii）皮肤病生活质量指数（DLQI）（范围0 - 30；从最佳到最差的HRQoL）；以及（iv）银屑病残疾指数（PDI）（范围0 - 45；分数越高表明HRQoL越好）。
结果
在V1时患者的平均（标准差）年龄为45.11（13.92）岁。银屑病发病时的平均年龄为26.08（14.19）岁。大多数患者为女性（61%）且已就业（68%）。V1时的平均PASI评分为13.24（9.50），V2时为5.07（6.03）（P <.001）。通用HRQoL问卷（EQ - 5D、SF - 36）的评分在所有测量维度上就诊之间均显示出显著改善（P <.001）。特定疾病问卷也显示随着时间推移生活质量总体改善：V1时DLQI平均总分是8.97（7.28），V2时为4.76（5.72）（P <.001），V1时PDI平均总分是9.24（8.76），V2时为4.88（6.65）（P <.001）。以PDI作为因变量的多变量分析表明，与HRQoL相关的主要因素是用PASI测量的银屑病严重程度（P <.001）和性别（P =.048）。
结论
银屑病患者HRQoL的主要相关因素是疾病的严重程度。
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