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[重症手足口病患者的健康相关生活质量]

[Health related quality of life on severe hand, foot and mouth disease patients].

作者信息

Zheng Y M, Yang J, Liao Q H

机构信息

Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Apr 10;38(4):462-466. doi: 10.3760/cma.j.issn.0254-6450.2017.04.010.

Abstract

To evaluate the health related quality of life (HRQoL) for severe hand, foot and mouth disease (HFMD) patients with different complications. A national telephone interview under the EQ-5D proxy2 questionnaire (EQ-SD and EQ-VAS), was conducted to obtain the HRQoL of lab-confirmed severe HFMD patients, aged between six months and five-year-olds from the national communicable disease surveillance system from January 1, 2012 to December 31, 2013. A total of 685 severe HFMD cases were included in the study. A total of 456 (66.6) of them were males with 75.8 of them younger than three years old. A total of 337 (49.2) and 407 (59.4) of the participants reported that they had problems in mobility or daily activities. A total of 569 (83.1) and 616 (89.9) of the cases reported having problems in pain/discomfort or anxiety/depression. The average EQ-5D and EQ-VAS scores were 0.58±0.23 and 53.6±25.7, both were positively associated with the duration of illness. Mean quality adjusted life years loss during the HFMD episode for the severe patients was (15.45±13.75) years/1 000 persons. The QALY losses for severe patients with each of below complication were: respiratory diseases (11.17±8.83) years/1 000 persons, aseptic meningitis (13.56±11.99) years/1 000 persons, encephalitis/brainstem encephalitis/acute flaccid paralysis (AFP) (15.31±12.63) years/1 000 persons, Myocarditis (17.28±18.16) years/1 000 persons, pulmonary hemorrhage/pulmonary edema (17.34±14.98) years/1 000 persons, cardiopulmonary failure (25.47±20.53) years/1 000 persons. Among patients with lab confirmed Entero virus A71 (EV71) (16.51±14.48) years/1 000 persons, the QALY loss was seen higher than Coxsackie virus A16 (Cox A16) (13.02±11.45) years/1 000 persons and other Enter virus (14.74±14.22) years/1 000 persons (=11.83, =0.003). The HRQoL loss for severe HFMD patients substantially increased under complications exacerbation and related to the duration of illness.

摘要

评估不同并发症的重症手足口病(HFMD)患者的健康相关生活质量(HRQoL)。采用EQ-5D代理问卷(EQ-SD和EQ-VAS)进行全国性电话访谈,以获取2012年1月1日至2013年12月31日期间国家传染病监测系统中6个月至5岁实验室确诊的重症HFMD患者的HRQoL。本研究共纳入685例重症HFMD病例。其中456例(66.6%)为男性,75.8%年龄小于3岁。共有337例(49.2%)和407例(59.4%)参与者报告他们在行动能力或日常活动方面存在问题。共有569例(83.1%)和616例(89.9%)病例报告有疼痛/不适或焦虑/抑郁问题。EQ-5D和EQ-VAS的平均得分分别为0.58±0.23和53.6±25.7,两者均与病程呈正相关。重症患者手足口病发作期间的平均质量调整生命年损失为(15.45±13.75)年/1000人。以下每种并发症的重症患者的QALY损失分别为:呼吸系统疾病(11.17±8.83)年/1000人、无菌性脑膜炎(13.56±11.99)年/1000人、脑炎/脑干脑炎/急性弛缓性麻痹(AFP)(15.31±12.63)年/1000人、心肌炎(17.28±18.16)年/1000人、肺出血/肺水肿(17.34±14.98)年/1000人、心肺衰竭(25.47±20.53)年/1000人。在实验室确诊为肠道病毒A71(EV71)的患者中(16.51±14.48)年/1000人,QALY损失高于柯萨奇病毒A16(Cox A16)(13.02±11.45)年/1000人和其他肠道病毒(14.74±14.22)年/1000人(F = 11.83,P = 0.003)。重症HFMD患者的HRQoL损失在并发症加重时大幅增加,且与病程有关。

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