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巨细胞动脉炎患者的视力相关和健康相关生活质量。

Vision-related and health-related quality of life in patients with giant cell arteritis.

机构信息

Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.

Department of Ophthalmology, RCSI School of Medicine, Dublin, Ireland.

出版信息

Eur J Ophthalmol. 2021 Mar;31(2):727-733. doi: 10.1177/1120672120901693. Epub 2020 Jan 20.

Abstract

OBJECTIVE

To establish if there is a difference in health-related quality of life and vision-related quality of life in patients with a confirmed diagnosis of giant cell arteritis compared with those with clinical features suspicious for the disease at initial presentation but in whom giant cell arteritis is ultimately excluded.

METHODS

A cross-sectional study of 116 patients who presented to two tertiary referral hospitals in Ireland with symptoms suspicious for giant cell arteritis was performed between August 2011 and June 2017. The Vision Core Measurement 1 and Short Form-36 questionnaires were used as assessment tools.

RESULTS

The mean (standard deviation) age of all 116 participants was 69.4 (9.3) years of whom 74 (63.8%) were female. In the giant cell arteritis group, 19.7% had permanent loss of vision and 54.7% had non-permanent visual disturbance. Vision Core Measurement 1 score in the giant cell arteritis group correlated with worse eye visual acuity (r = 0.4233, p = 0.0002). The Short Form-36 subscales of role physical (p = 0.0002), role emotional (p = 0.024), and the mental composite score (p = 0.012) were significantly worse in patients with giant cell arteritis. A significant correlation was found between vision-related quality of life scores and all Short Form-36 subscale scores except bodily pain (r = -0.215 to -0.399, p < 0.05 for all), and between social functioning and visual acuity in the better eye (r = -0.242, p = 0.038).

CONCLUSION

Vision-related quality of life is an important subjective concern for both patients presenting with a suspicion of giant cell arteritis and those with a definite diagnosis of giant cell arteritis. Features of giant cell arteritis impact on patients' physical and emotional states and vision influences global quality of life in giant cell arteritis. A long-term multidisciplinary approach is warranted for clinical, physical, and psychological treatment and support.

摘要

目的

确定经临床确诊的巨细胞动脉炎患者与最初表现出巨细胞动脉炎临床特征但最终排除巨细胞动脉炎的患者相比,其健康相关生活质量和视力相关生活质量是否存在差异。

方法

对 2011 年 8 月至 2017 年 6 月间在爱尔兰两家三级转诊医院就诊的 116 例疑似巨细胞动脉炎症状的患者进行了横断面研究。使用视力核心测量 1 和简明 36 健康状况调查简表作为评估工具。

结果

116 名参与者的平均(标准差)年龄为 69.4(9.3)岁,其中 74 名(63.8%)为女性。在巨细胞动脉炎组中,19.7%的患者永久性失明,54.7%的患者存在非永久性视力障碍。巨细胞动脉炎组的视力核心测量 1 评分与较差的视力(r=0.4233,p=0.0002)相关。巨细胞动脉炎患者的简明 36 健康状况调查简表的身体角色(p=0.0002)、情感角色(p=0.024)和精神综合评分(p=0.012)等子量表评分明显较差。视力相关生活质量评分与除躯体疼痛外的所有简明 36 健康状况调查简表子量表评分(r=-0.215 至-0.399,p<0.05)以及社会功能与较好眼视力之间存在显著相关性(r=-0.242,p=0.038)。

结论

视力相关生活质量是疑似巨细胞动脉炎患者和确诊巨细胞动脉炎患者均关注的重要主观问题。巨细胞动脉炎的特征会影响患者的身体和情绪状态,而视力则会影响巨细胞动脉炎患者的整体生活质量。需要采取长期的多学科方法进行临床、身体和心理治疗和支持。

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