Li Maojuan, Tao Yan, Sun Yang, Wu Jing, Zhang Fengrui, Wen Yunling, Gong Min, Yan Jingxian, Liang Hao, Bai Xinyu, Niu Junkun, Miao Yinglei
Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China.
Front Med (Lausanne). 2023 Mar 9;10:1041505. doi: 10.3389/fmed.2023.1041505. eCollection 2023.
This study aimed to determine the factors affecting the quality of life of patients with inflammatory bowel disease (IBD) and to construct a disease recurrence prediction model based on these influencing factors.
A prospective, single-center study in China was conducted between October 2020 and March 2021. The quality of life of patients was assessed using the Inflammatory Bowel Disease Questionnaire (IBDQ). Multiple stepwise regression analysis was used to analyze the factors influencing the quality of life of patients with IBD. The chi-square test and the point-biserial correlation analysis were performed to identify factors associated with clinical recurrence. A binary logistic regression model was constructed to predict the recurrence. The receiver operating characteristic curve was used to evaluate the prediction model. Patients with IBD from April 2021 to June 2021 were randomly included for model verification to evaluate the disease recurrence prediction model.
The average IBDQ score of patients with IBD was 172.2 ± 35.0 (decreased by 23.2%). The scores of all dimensions of the IBDQ were decreased, especially emotional function and systemic symptoms. Disease activity, age, extraintestinal manifestations (EIMs), and annual household income were important factors influencing the IBDQ scores of patients with ulcerative colitis, and these accounted for ~57.0% of the factors affecting the quality of life. Disease activity, EIMs, and occupational stress were important factors influencing the IBDQ scores of patients with Crohn's disease, and they accounted for approximately 75.1% of the factors affecting the quality of life. Annual household income, occupational stress, and IBDQ scores were independent risk factors for recurrence. The area under the curve of the recurrence prediction model was 81.1%. The sensitivity and specificity were 81.7 and 71.7%, respectively. The Youden index of the model was 0.534. The established recurrence prediction model has good discriminant validity in the validation cohort.
The quality of life of patients with IBD was generally poor. The use of factors affecting the quality of life to predict disease recurrence has high predictive value and can support the management of IBD by selecting patients at a higher risk for relapse.
本研究旨在确定影响炎症性肠病（IBD）患者生活质量的因素，并基于这些影响因素构建疾病复发预测模型。
于2020年10月至2021年3月在中国开展了一项前瞻性单中心研究。采用炎症性肠病问卷（IBDQ）评估患者的生活质量。运用多元逐步回归分析来分析影响IBD患者生活质量的因素。进行卡方检验和点二列相关分析以确定与临床复发相关的因素。构建二元逻辑回归模型来预测复发情况。采用受试者工作特征曲线评估预测模型。随机纳入2021年4月至2021年6月的IBD患者进行模型验证，以评估疾病复发预测模型。
IBD患者的IBDQ平均得分为172.2±35.0（下降了23.2%）。IBDQ各维度得分均下降，尤其是情绪功能和全身症状。疾病活动度、年龄、肠外表现（EIMs）和家庭年收入是影响溃疡性结肠炎患者IBDQ得分的重要因素，这些因素占影响生活质量因素的约57.0%。疾病活动度、EIMs和职业压力是影响克罗恩病患者IBDQ得分的重要因素，它们占影响生活质量因素的约75.1%。家庭年收入、职业压力和IBDQ得分是复发的独立危险因素。复发预测模型的曲线下面积为81.1%。灵敏度和特异度分别为81.7%和71.7%。该模型的约登指数为0.534。所建立的复发预测模型在验证队列中具有良好的判别效度。
IBD患者的生活质量普遍较差。利用影响生活质量的因素预测疾病复发具有较高的预测价值，可为通过选择复发风险较高的患者来管理IBD提供支持。
