Casellas Francisco, Rodrigo Luis, Lucendo Alfredo J, Fernández-Bañares Fernando, Molina-Infante Javier, Vivas Santiago, Rosinach Mercé, Dueñas Carmen, López-Vivancos Josefa
Rev Esp Enferm Dig. 2015 Apr;107(4):196-201.
Celiac disease (CD) affects health-related quality of life (HRQOL) of patients suffering it. The exclusion of gluten from the diet (GFD) improves HRQOL, but involves difficulties in following the diet that could adversely affect HRQOL.
To determine the effect of adherence to the diet on HRQOL of adult CD patients.
A prospective, cross-sectional, multicenter study of CD patients treated with a GFD for longer than 1 year. Adherence to the GFD was measured using the Morisky scale, and health status using the specific CD-QOL questionnaire and the generic EuroQol-5D questionnaire.
366 patients from 7 hospitals were included: 71.5% of patients reported a perfect treatment adherence, 23.5% unintentional poor adherence and 5% intentional poor adherence. Good adherence to a GFD was related to a higher mean score onthe CD-QOL (75 vs. 68, respectively, p < 0.05) and EuroQol-5D (0.9 vs. 0.8, respectively, p < 0.05). Ease of adherence to a GFD was also related to a better HRQOL (total CD-QOL score of 82 vs. 67 in patients who consider the GFD difficult to follow, p < 0.05). Good symptom control was also related to a better HRQOL (total CD-QOL score of 78 vs. 67 in asymptomatic vs. symptomatic patients, p < 0.01). The worse scored dimension of CD-QOL was related to "inadequate treatment".
In CD, good adherence to a GFD and adequate symptom control result in improved HRQOL. Many patients consider that the lack of therapeutic alternatives to diet worsens their quality of life.
乳糜泻（CD）会影响患者的健康相关生活质量（HRQOL）。饮食中排除麸质（GFD）可改善HRQOL，但遵循该饮食存在困难，这可能对HRQOL产生不利影响。
确定坚持饮食对成年CD患者HRQOL的影响。
对接受GFD治疗超过1年的CD患者进行一项前瞻性、横断面、多中心研究。使用Morisky量表测量对GFD的依从性，并使用特定的CD-QOL问卷和通用的EuroQol-5D问卷测量健康状况。
纳入了来自7家医院的366名患者：71.5%的患者报告完全坚持治疗，23.5%为无意的依从性差，5%为有意的依从性差。良好的GFD依从性与CD-QOL（分别为75分和68分，p<0.05）和EuroQol-5D（分别为0.9和0.8，p<0.05）的较高平均得分相关。易于坚持GFD也与更好的HRQOL相关（认为GFD难以遵循的患者的CD-QOL总分为82分，而另一组为67分，p<0.05）。良好的症状控制也与更好的HRQOL相关（无症状患者与有症状患者的CD-QOL总分为78分和67分，p<0.01）。CD-QOL得分最差的维度与“治疗不足”有关。
在CD中，良好的GFD依从性和充分的症状控制可改善HRQOL。许多患者认为缺乏饮食以外的治疗选择会使他们的生活质量恶化。
