Rodríguez Almagro Julián, Hernández Martínez Antonio, Lucendo Alfredo José, Casellas Francesc, Solano Ruiz Maria Carmen, Siles González José
Emergency Services, Hospital General Universitario, ESPAÑA.
Nurse midwife teaching Unit, Hospital General Mancha Centro, España.
Rev Esp Enferm Dig. 2016 Apr;108(4):181-9. doi: 10.17235/reed.2016.4094/2015.
Celiac disease (CD) has a negative impact on the health-related quality of life (HRQL) of affected patients. Although HRQL and its determinants have been examined in Spanish CD patients specifically recruited in hospital settings, these aspects of CD have not been assessed among the general Spanish population.
An observational, transversal study of a non-randomized, representative sample of adult celiac patients throughout all of Spain's Autonomous Regions. Subjects were recruited through celiac patient associations. A Spanish version of the self-administered Celiac Disease-Quality of Life (CD-QOL) questionnaire was used. Determinant factors of HRQL were assessed with the aid of multivariate analysis to control for confounding factors.
We analyzed the responses provided by 1,230 patients, 1,092 (89.2%) of whom were women. The overall mean value for the CD-QOL index was 56.3 ± 18.27 points. The dimension that obtained the most points was dysphoria, with 81.3 ± 19.56 points, followed by limitations with 52.3 ± 23.43 points; health problems, with 51.6 ± 26.08 points, and inadequate treatment, with 36.1 ± 21.18 points. Patient age and sex, along with time to diagnosis, and length of time on a gluten-free diet were all independent determinant factors of certain dimensions of HRQL: women aged 31 to 40 expressed poorer HRQL while time to diagnosis and length of time on a gluten-free diet were determinant factors for better HRQL scores.
The HRQL of adult Spanish celiac subjects is moderate, improving with the length of time patients remain on a gluten-free diet.
乳糜泻（CD）对受影响患者的健康相关生活质量（HRQL）有负面影响。尽管已在专门在医院环境中招募的西班牙CD患者中对HRQL及其决定因素进行了研究，但尚未在西班牙普通人群中评估CD的这些方面。
对西班牙所有自治区的成年乳糜泻患者进行非随机、代表性样本的观察性横断面研究。通过乳糜泻患者协会招募受试者。使用了西班牙语版的自我管理乳糜泻生活质量（CD-QOL）问卷。借助多变量分析评估HRQL的决定因素，以控制混杂因素。
我们分析了1230名患者的回答，其中1092名（89.2%）为女性。CD-QOL指数的总体平均值为56.3±18.27分。得分最高的维度是烦躁不安，为81.3±19.56分，其次是限制，为52.3±23.43分；健康问题为51.6±26.08分，治疗不足为36.1±21.18分。患者的年龄和性别，以及诊断时间和无麸质饮食的时间长短都是HRQL某些维度的独立决定因素：31至40岁的女性HRQL较差，而诊断时间和无麸质饮食的时间长短是HRQL得分较高的决定因素。
成年西班牙乳糜泻患者的HRQL中等，随着患者无麸质饮食时间的延长而改善。
