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中国痛风患者功能残疾及健康相关生活质量的相关因素:一项病例对照研究

Associated factors with functional disability and health-related quality of life in Chinese patients with gout: a case-control study.

作者信息

Fu Ting, Cao Haixia, Yin Rulan, Zhang Lijuan, Zhang Qiuxiang, Li Liren, Gu Zhifeng

机构信息

Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China.

Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China.

出版信息

BMC Musculoskelet Disord. 2017 Nov 3;18(1):429. doi: 10.1186/s12891-017-1787-7.

Abstract

BACKGROUND

Gout is a painful, inflammatory disease that may cause decreased function and health-related quality of life (HRQoL). Limited study did not take the influence of gout characteristics and anxiety on HRQoL into consideration and there are no studies associated with functional disability in individuals with gout from China. This study aims to investigate the related factors of functional disability and HRQoL in gout patients recruited from China.

METHODS

A total of 226 consecutive gout patients and 232 age- and gender-matched healthy individuals were involved in the study. A series of questionnaires (the Short Form 36 health survey, the Patient Health Questionnaire, the Generalized Anxiety Disorder questionnaire, the 10 cm Visual Analog Scale, and the Health Assessment Questionnaire-Disability Index) were applied. Blood samples were taken to examine the level of serum uric acid. Independent samples t-tests, Chi square tests, U test, Spearman rank correlation, logistic regression modeling, and linear regression were used to analyze the data.

RESULTS

After adjusted demographic variables, individuals with gout have poorer HRQoL compared to healthy controls. Univariate tests presented that patients with functional disability had longer disease duration, more frequent flares/last year, more severe total pain, more number of tophi, higher degree of depression and anxiety, with a trend toward diabetes, the treatment of colchicine and corticosteroids use, compared to patients without functional disability. Meanwhile, place of residence, hypertension, DM, disease duration, cardiovascular disease, number of flares/last year, total pain, more number of tophi, presence of tender joints, depression, anxiety, currently using colchicine and corticosteroids were correlated significantly with HRQoL. Additionally, multiple regression analysis identified severe pain, depression, and colchicine use as predictors of functional disability. Cardiovascular disease, total pain, number of flares/last year, presence of tender joints, depression, anxiety, colchicine and corticosteroids use contributed to low HRQoL.

CONCLUSIONS

After adjusted demographic variables, gout subjects have poorer HRQoL compared to healthy controls. Chinese gout population experiencing poor HRQoL and functional disability were likely to suffer from gout-related features and psychological problems. The results underscore the need of effective interventions including psychological nursing and appropriate treatment approaches to reduce their functional disability and improve their HRQoL.

摘要

背景

痛风是一种疼痛性炎症性疾病,可能导致功能下降和与健康相关的生活质量(HRQoL)降低。有限的研究未考虑痛风特征和焦虑对HRQoL的影响,且尚无关于中国痛风患者功能残疾的研究。本研究旨在调查招募自中国的痛风患者功能残疾和HRQoL的相关因素。

方法

本研究共纳入226例连续的痛风患者和232例年龄及性别匹配的健康个体。应用了一系列问卷(简明健康调查问卷、患者健康问卷、广泛性焦虑障碍问卷、10厘米视觉模拟量表和健康评估问卷 - 残疾指数)。采集血样以检测血清尿酸水平。采用独立样本t检验、卡方检验、U检验、Spearman等级相关、逻辑回归建模和线性回归进行数据分析。

结果

调整人口统计学变量后,痛风患者的HRQoL较健康对照者差。单因素检验显示,与无功能残疾的患者相比,有功能残疾的患者病程更长、每年发作更频繁、总疼痛更严重、痛风石数量更多、抑郁和焦虑程度更高,有患糖尿病的趋势,使用秋水仙碱和皮质类固醇进行治疗。同时,居住地、高血压、糖尿病、病程、心血管疾病、每年发作次数、总疼痛、痛风石数量更多、压痛关节的存在、抑郁、焦虑、目前使用秋水仙碱和皮质类固醇与HRQoL显著相关。此外,多元回归分析确定严重疼痛、抑郁和秋水仙碱的使用是功能残疾的预测因素。心血管疾病、总疼痛、每年发作次数、压痛关节的存在、抑郁、焦虑、秋水仙碱和皮质类固醇的使用导致HRQoL较低。

结论

调整人口统计学变量后,痛风患者的HRQoL较健康对照者差。中国痛风人群HRQoL较差且存在功能残疾,可能患有与痛风相关的特征和心理问题。结果强调需要采取包括心理护理和适当治疗方法在内的有效干预措施,以减少其功能残疾并改善其HRQoL。

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