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重症肌无力患者生活质量的决定因素

Determinants of Quality of Life in Myasthenia Gravis Patients.

作者信息

Szczudlik Piotr, Sobieszczuk Ewa, Szyluk Beata, Lipowska Marta, Kubiszewska Justyna, Kostera-Pruszczyk Anna

机构信息

Department of Neurology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Front Neurol. 2020 Sep 23;11:553626. doi: 10.3389/fneur.2020.553626. eCollection 2020.

Abstract

Although approximately half of myasthenia gravis (MG) patents achieve remission, for the remaining group MG is often a life-long disease. Better understanding of the determinants of Quality of Life (QoL) in MG is needed to optimize treatment goals in chronic cases. We performed a single center cross-sectional study in 339 MG adult patients (64.9% women), with ocular or generalized disease. SF-36 and a structured questionnaire was administered, including information on previous and current MG severity, medications, comorbidities, education, occupation and BMI of the patient. Mean disease duration was 7.5 + 9.3 years. Current age was 51.6 + 18.3 years, 55% had Early-Onset (<50 years) MG. There were no statistically significant differences in mean SF-36 subscores between women and men. Worse MGFA class was related to lower QoL in physical (PCS) and mental (MCS) subscore ( = 0.000 for both). Patients with MGFA I-II class had significantly better QoL in physical and mental subscores than patients with more severe MG ( < 0.005). Late-onset MG patients had worse QoL than EOMG in physical score domain PCS ( = 0.049). Overweight and obese patients had lower PCS ( = 0.002) and MCS ( = 0.038) than patients with normal BMI. University education was related to statistically higher PCS ( = 0.015) and MCS ( = 0.006). QoL in currently employed was better in PCS and MCS ( = 0.000), with white collar workers reporting higher PCS ( = 0.049) than the remaining group. Patients living with family evaluated their MCS ( = 0.015) better than living alone. Moderate physical activity (twice a week) improved PCS ( = 0.045). Our study confirmed that greater severity of symptoms, age, age of onset but also BMI, type of work, education status and physical activity affect QoL in MG.

摘要

虽然约一半的重症肌无力(MG)患者可实现缓解,但对于其余患者而言,MG往往是一种终身疾病。为了优化慢性病例的治疗目标,需要更好地了解MG患者生活质量(QoL)的决定因素。我们对339例成年MG患者(64.9%为女性)进行了一项单中心横断面研究,这些患者患有眼肌型或全身型疾病。采用了SF-36量表和一份结构化问卷,其中包括患者既往和当前MG严重程度、用药情况、合并症、教育程度、职业以及体重指数(BMI)等信息。平均病程为7.5±9.3年。当前年龄为51.6±18.3岁,55%患有早发型(<50岁)MG。女性和男性在SF-36各子量表的平均得分上无统计学显著差异。MGFA分级越差,身体(PCS)和心理(MCS)子量表的QoL越低(两者均P = 0.000)。MGFA I-II级患者在身体和心理子量表上的QoL显著优于病情更严重的MG患者(P < 0.005)。晚发型MG患者在身体得分领域PCS方面的QoL比早发型MG患者差(P = 0.049)。超重和肥胖患者的PCS(P = 0.002)和MCS(P = 0.038)低于BMI正常的患者。大学教育程度与统计学上更高的PCS(P = 0.015)和MCS(P = 0.006)相关。目前有工作的患者在PCS和MCS方面的QoL更好(P = 0.000),白领工作人员的PCS高于其他组(P = 0.049)。与家人同住患者对其MCS的评价优于独居患者(P = 0.015)。适度体育活动(每周两次)可改善PCS(P = 0.045)。我们的研究证实,症状严重程度、年龄、发病年龄以及BMI、工作类型、教育状况和体育活动都会影响MG患者的QoL。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b43/7538807/cde2b67930a9/fneur-11-553626-g0001.jpg

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