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临床孤立综合征与向多发性硬化转化的健康相关生活质量。

Health-related quality of life in clinically isolated syndrome and risk of conversion to multiple sclerosis.

机构信息

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Department of Global Public Health and Primary Care, Bergen University, Bergen, Norway.

出版信息

Neurol Sci. 2019 Jan;40(1):75-80. doi: 10.1007/s10072-018-3582-0. Epub 2018 Sep 25.

Abstract

BACKGROUND AND OBJECTIVES

A few studies have found that low scores on self-rated health and quality of life measures are associated with following worsening disability in multiple sclerosis (MS). We wanted to estimate the association between self-rated quality of life scores among patients with clinically isolated syndrome (CIS) and the risk of subsequent conversion to definite MS.

METHODS

One hundred sixty-two patients from the GERONIMUS cohort with a symptom or sign suggestive of MS and without a definite diagnosis of MS at the time of inclusion were asked to evaluate their health-related quality of life according to MSQoL-54 scale. They were clinically assessed and mood and depression scales were applied. The association between the scores of these scales and the risk of converting to definite MS during a 5-year follow-up was estimated using the Cox- proportional hazard regression model.

RESULTS

Quality of life at examination was significantly lower compared to those of an age- and sex-adjusted general Italian population. During the follow-up, 116 patients (72%) converted to definite MS. No significant predictive effects were found for the summary scales of MSQol-54 or other scales. The estimates did not change after adjusting for age, sex, BMI, education, MRI findings, Expanded Disability Status Scale (EDSS) score, and treatment at time of examination.

CONCLUSION

Persons with CIS in this cohort reported reduced self-rated quality of life compared to the general population, but variation in these scores was not associated with subsequent conversion from CIS to clinical definite MS.

摘要

背景和目的

一些研究发现,自我报告的健康状况和生活质量评分较低与多发性硬化症(MS)患者的残疾恶化有关。我们想评估临床孤立综合征(CIS)患者的自我报告生活质量评分与随后转为明确 MS 的风险之间的关联。

方法

GERONIMUS 队列中的 162 名患者出现了提示 MS 的症状或体征,且在纳入时没有明确的 MS 诊断,他们被要求根据 MSQoL-54 量表评估他们的健康相关生活质量。对他们进行临床评估并应用情绪和抑郁量表。使用 Cox 比例风险回归模型来估计这些量表的评分与在 5 年随访期间转化为明确 MS 的风险之间的关联。

结果

与年龄和性别调整后的一般意大利人群相比,检查时的生活质量明显较低。在随访期间,116 名患者(72%)转为明确 MS。MSQol-54 量表的综合评分或其他量表没有发现显著的预测效果。调整检查时的年龄、性别、BMI、教育程度、MRI 发现、扩展残疾状态量表(EDSS)评分和治疗后,估计值没有变化。

结论

该队列中的 CIS 患者报告的自我评定生活质量低于一般人群,但这些评分的变化与从 CIS 转为临床明确 MS 无关。

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