Mahassadi Alassan Kouamé, Ebela Paulin Christian, Bangoura Aboubacar Demba, Attia Alain Koffi
Hepatology and Gastroenterology Unit, Centre Hospitalier et Universitaire de Yopougon, Abidjan, Côte d'Ivoire.
Clin Exp Gastroenterol. 2019 Aug 2;12:355-365. doi: 10.2147/CEG.S192563. eCollection 2019.
Although patients with irritable bowel syndrome (IBS) and chronic constipation (CC) have an impaired health-related quality of life (HRQoL), little is known in black African patients compared with control subjects. This study provided the magnitude and the influencing factors of HRQoL impairment in black African outpatients with IBS or CC compared with control subjects using the generic SF-36 questionnaire. One hundred and four consecutive black African outpatients complaining with IBS (n=72, mean age=38.9 years, female=62.5%) and CC (n=32, mean age=37.4 years, female=75%) met Rome 3 criteria were compared with 210 control subjects (mean age=37.4 years, 63.8% male). The SF-36 scores in all domains of HRQoL with the corresponding physical (PCS) and mental (MCS) composite scores between groups were compared with post hoc analysis and multivariate linear regression analysis for the assessment of the influencing factors. Overall, IBS and CC patients exhibited low SF-36 scores in the 8 domains of HRQoL in comparison with control subjects. IBS patients scored less in mental health (mean difference=-10.3, =0.001), bodily pain (mean difference=-23.5, ≤0.0001), and social functioning domains (mean difference =-15.1, =0.01) in comparison with CC patients. Post hoc analysis demonstrated a trend down of PCS (mean difference=-12.9, <0.0001) and MCS (mean difference=-11.2, =0.01) disfavoring IBS patients than those with CC in comparison with control subjects. In multivariate linear regression analysis, besides the negative impact of IBS and CC, factors influencing PCS were BMI (β=0.4; =0.01) and comorbidities (β=-5.9; =0.002). Those influencing MCS were the presence of remunerated activity (β=2.7, =0.02), and patient living alone (β=9.4; =0.04). IBS and CC impact negatively on the HRQoL in black African subjects and more importantly in those with IBS than CC.
尽管肠易激综合征(IBS)和慢性便秘(CC)患者的健康相关生活质量(HRQoL)受损,但与对照组相比,关于非洲黑人患者的情况却知之甚少。本研究使用通用的SF - 36问卷,探讨了与对照组相比,非洲黑人门诊IBS或CC患者HRQoL受损的程度及影响因素。将104例符合罗马Ⅲ标准、连续就诊的非洲黑人门诊患者[IBS组(n = 72,平均年龄 = 38.9岁,女性占62.5%)和CC组(n = 32,平均年龄 = 37.4岁,女性占75%)]与210例对照组患者(平均年龄 = 37.4岁,男性占63.8%)进行比较。采用事后分析和多元线性回归分析比较了各组间HRQoL所有领域的SF - 36评分以及相应的生理(PCS)和心理(MCS)综合评分,以评估影响因素。总体而言,与对照组相比,IBS和CC患者在HRQoL的8个领域中SF - 36评分较低。与CC患者相比,IBS患者在心理健康(平均差值 = - 10.3,P = 0.001)、身体疼痛(平均差值 = - 23.5,P≤0.0001)和社会功能领域(平均差值 = - 15.1,P = 0.01)的得分更低。事后分析显示,与对照组相比,IBS患者的PCS(平均差值 = - 12.9,P < 0.0001)和MCS(平均差值 = - 11.2,P = 0.01)呈下降趋势,且比CC患者更差。在多元线性回归分析中,除了IBS和CC的负面影响外,影响PCS的因素有BMI(β = 0.4;P = 0.01)和合并症(β = - 5.9;P = 0.002)。影响MCS的因素有有偿活动(β = 2.7,P = 0.02)以及患者独居(β = 9.4;P = 0.04)。IBS和CC对非洲黑人患者的HRQoL有负面影响,更重要的是,IBS患者的影响比CC患者更大。