Junkkari A, Sintonen H, Nerg O, Koivisto A M, Roine R P, Viinamäki H, Soininen H, Jääskeläinen J E, Leinonen V
Neurosurgery of NeuroCenter, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.
Hjelt Institute/Department of Public Health, University of Helsinki, Helsinki, Finland.
Eur J Neurol. 2015 Oct;22(10):1391-9. doi: 10.1111/ene.12755. Epub 2015 Jun 24.
Factors affecting health-related quality of life (HRQoL) were explored in patients with idiopathic normal pressure hydrocephalus (iNPH).
Using the 15D instrument HRQoL was evaluated in 132 patients diagnosed with iNPH by clinical and neuroradiological examinations. The severity of iNPH symptoms was measured with the iNPH grading scale (iNPHGS), depressive symptoms with the Beck Depression Inventory (BDI-21) and cognitive impairment with the Mini-Mental State Examination.
The mean (SD) 15D score (on a 0-1 scale) of patients with iNPH was significantly lower than that of an age- and gender-matched sample of the general population [0.718 (0.103) vs. 0.870 (0.106); P < 0.001]. The mean 15D score was lower in iNPH patients with moderate or severe depressive symptoms than in patients without depressive symptoms (P = 0.003). According to stepwise multiple linear regression analysis, a higher total iNPHGS score (b = -0.62, P < 0.001) and a higher BDI-21 total score (β = -0.201, P = 0.025) predicted a lower 15D score; in combination, these explained 51% of the variance in the 15D score (R(2) = 0.506, P < 0.001).
Idiopathic normal pressure hydrocephalus impairs patients' HRQoL on multiple dimensions, similarly to other chronic diseases. Potentially treatable depressive symptoms contribute greatly to the HRQoL impairment of iNPH patients, but only if they are moderate or severe. The 15D portrayed HRQoL dimensions affected by iNPH in a similar way to broader assessment batteries and thus is a potentially useful tool for treatment evaluation and cost-utility analysis.
探讨特发性正常压力脑积水（iNPH）患者健康相关生活质量（HRQoL）的影响因素。
采用15D量表对132例经临床和神经影像学检查确诊为iNPH的患者进行HRQoL评估。采用iNPH分级量表（iNPHGS）测量iNPH症状的严重程度，采用贝克抑郁量表（BDI-21）测量抑郁症状，采用简易精神状态检查表测量认知障碍。
iNPH患者的平均（标准差）15D评分（0-1分制）显著低于年龄和性别匹配的一般人群样本[0.718（0.103）对0.870（0.106）；P<0.001]。中度或重度抑郁症状的iNPH患者的平均15D评分低于无抑郁症状的患者（P=0.003）。根据逐步多元线性回归分析，较高的iNPHGS总分（b=-0.62，P<0.001）和较高的BDI-21总分（β=-0.201，P=0.025）预示着较低的15D评分；综合起来，这些因素解释了15D评分中51%的方差（R²=0.506，P<0.001）。
与其他慢性疾病类似，特发性正常压力脑积水在多个维度损害患者的HRQoL。潜在可治疗的抑郁症状对iNPH患者的HRQoL损害有很大影响，但仅在症状为中度或重度时如此。15D量表描绘的iNPH影响的HRQoL维度与更广泛的评估量表相似，因此是治疗评估和成本效益分析的潜在有用工具。
