神经脱髓鞘疾病患者在阿根廷队列中的健康相关生活质量。
Health-related quality of life in neuromyelitis optica spectrum disorder patients in an Argentinean cohort.
机构信息
Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina.
Multiple Sclerosis University Center, J.M. Ramos Mejía Hospital, Buenos Aires, Argentina.
出版信息
Mult Scler Relat Disord. 2022 Mar;59:103647. doi: 10.1016/j.msard.2022.103647. Epub 2022 Jan 31.
BACKGROUND
We aimed to describe the health-related quality of life (HRQoL) in patients with neuromyelitis optica spectrum disorders (NMOSD), to compare HRQoL between NMOSD patients, multiple sclerosis (MS), and healthy controls (HC) and to study the associations between HRQoL and the clinical variables of the disease.
METHODS
A cross-sectional study was carried out. Patients with NMOSD seropositive, MS, and HC were enrolled and age-matched. The HRQoL was studied using the Argentinean validation of the SF-36 health questionnaire. Demographic and clinical characteristics were analyzed, as well as the EDSS and the total scores and subscales of the SF-36.
RESULTS
243 individuals were included (NMOSD= 53, MS =100, and HC =90). The mean EDSS was 3.06 ± 2.01 in NMOSD and 2.67 ± 1.83 in MS with a mean of disease duration of 6.2 ± 4.4 and 6.3 ± 5.3 years, respectively. Significant statistical differences were observed in the total SF-36 score between both NMOSD and MS vs. HC (p < 0.01), but no differences were found when the total SF-36 score was compared between NMOSD vs. MS. Overall, NMOSD patients scored significantly lower in the total SF-36 and subscale scores compared to HC (p< 0.05). NMOSD patients also showed significant differences in bodily pain (58.8 ± 29.8 vs 75.1 ± 25.1, p < 0.01) and general health (44.4 ± 20.9 vs.31.9 ± 23.1, p < 0.01) when compared with MS, but no differences were found after comparing the rest of the subscales. We found that higher EDSS scores (β -1.28 p = 0.03) and disease duration (β 0.8, p = 0.02) were significantly associated to lower (worse) general health (dependent variable) score in NMOSD patients after having applied multiple linear regression analysis. Additionally, we observed that higher EDSS scores (β -10.2 p = 0.008) and the presence of relapses in the previous year (β -28.9, p = 0.02) were significantly associated to lower (worse) physical functioning (dependent variable) score.
CONCLUSION
Pain seems to be a significant undertreated symptom in NMOSD patients that strongly impact on HRQoL. Patient-reported HRQoL scales scores provide comprehensive additional prognostic information beyond physical disability score.
背景
本研究旨在描述视神经脊髓炎谱系疾病（NMOSD）患者的健康相关生活质量（HRQoL），比较 NMOSD 患者、多发性硬化症（MS）患者和健康对照组（HC）之间的 HRQoL，并研究 HRQoL 与疾病临床变量之间的相关性。
方法
本研究为横断面研究。纳入 NMOSD 血清阳性、MS 和 HC 患者，并进行年龄匹配。采用阿根廷版 SF-36 健康问卷评估 HRQoL。分析人口统计学和临床特征，以及 EDSS 评分和 SF-36 的总分和各分量表得分。
结果
共纳入 243 名患者（NMOSD=53 例、MS=100 例、HC=90 例）。NMOSD 患者的平均 EDSS 为 3.06±2.01，MS 患者为 2.67±1.83，NMOSD 和 MS 患者的平均病程分别为 6.2±4.4 年和 6.3±5.3 年。NMOSD 和 MS 患者的 SF-36 总分与 HC 相比均有显著统计学差异（p<0.01），但 NMOSD 与 MS 患者的 SF-36 总分之间无显著差异。总体而言，NMOSD 患者的 SF-36 总分和各分量表得分均明显低于 HC（p<0.05）。NMOSD 患者在躯体疼痛（58.8±29.8 比 75.1±25.1，p<0.01）和一般健康（44.4±20.9 比 31.9±23.1，p<0.01）方面与 MS 患者相比差异有统计学意义，但在比较其他各分量表后，差异无统计学意义。我们发现，NMOSD 患者经多线性回归分析后，较高的 EDSS 评分（β -1.28，p=0.03）和疾病病程（β 0.8，p=0.02）与一般健康（依赖变量）评分的降低（更差）有显著相关性。此外，我们观察到较高的 EDSS 评分（β -10.2，p=0.008）和前一年的复发（β -28.9，p=0.02）与身体机能（依赖变量）评分的降低（更差）有显著相关性。
结论
疼痛似乎是 NMOSD 患者一个严重的治疗不足的症状，对 HRQoL 有强烈影响。患者报告的 HRQoL 量表评分提供了物理残疾评分之外的综合预后信息。
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