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炎症性肠病患者生活质量的相关趋势及因素

Trends and Factors Related to Quality of Life in Patients with Inflammatory Bowel Disease.

作者信息

Kim Sihyun, Jun Yu Kyung, Choi Yonghoon, Shin Cheol Min, Park Young Soo, Kim Nayoung, Lee Dong Ho, Yoon Hyuk

机构信息

Division of Gastroenterology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Gut Liver. 2025 Mar 15;19(2):236-242. doi: 10.5009/gnl240172. Epub 2024 Nov 7.

Abstract

BACKGROUND/AIMS: Inflammatory bowel disease (IBD) affects health-related quality of life (HRQoL). The Short Inflammatory Bowel Disease Questionnaire (SIBDQ) score is strongly correlated with HRQoL in IBD patients. This study aimed to assess the factors influencing HRQoL in IBD patients.

METHODS

In this prospective study, all patients with ulcerative colitis (UC) and Crohn's disease (CD) completed the SIBDQ at enrollment; some patients also completed a second SIBDQ at follow-up. Multiple linear regression analysis was used to determine associations between SIBDQ scores and clinical factors.

RESULTS

A total of 1,020 patients participated (UC, 67%; CD, 33%). The median SIBDQ score was 52 (interquartile range, 44 to 59). In UC patients, the stool frequency (β=-2.333, p<0.001), Physician Global Assessment score (β=-3.950, p<0.001), fecal calprotectin level (β=-4.014, p<0.001), and corticosteroid use (β=-4.809, p=0.006) were negatively correlated with the SIBDQ score. In CD patients, the number of diarrhea episodes per day (β=-1.467, p=0.024) and Crohn's Disease Activity Index score (β=-0.045, p<0.001) were negatively correlated with the SIBDQ score. A total of 202 patients completed the second SIBDQ within a mean of 3.4 years. The distributions of SIBDQ score changes were as follows: decrease >10%, 28%; -10%<change<10%, 29%; and increase >10%, 43%. In both the initial SIBDQ and follow-up SIBDQ, scores for items pertaining to systemic symptoms (tension and fatigue) were relatively low.

CONCLUSIONS

Bowel movement-related problems significantly affect the HRQoL of both UC and CD patients. IBD patients scored lower on SIBDQ items related to general well-being. After 3 years of follow-up at the IBD clinic, 43% of patients showed a significant improvement in HRQoL.

摘要

背景/目的:炎症性肠病(IBD)会影响健康相关生活质量(HRQoL)。简短炎症性肠病问卷(SIBDQ)评分与IBD患者的HRQoL密切相关。本研究旨在评估影响IBD患者HRQoL的因素。

方法

在这项前瞻性研究中,所有溃疡性结肠炎(UC)和克罗恩病(CD)患者在入组时完成SIBDQ;部分患者在随访时还完成了第二次SIBDQ。采用多元线性回归分析确定SIBDQ评分与临床因素之间的关联。

结果

共有1020例患者参与(UC占67%;CD占33%)。SIBDQ评分中位数为52(四分位间距为44至59)。在UC患者中,排便频率(β=-2.333,p<0.001)、医生整体评估评分(β=-3.950,p<0.001)、粪便钙卫蛋白水平(β=-4.014,p<0.001)和使用皮质类固醇(β=-4.809,p=0.006)与SIBDQ评分呈负相关。在CD患者中,每日腹泻发作次数(β=-1.467,p=0.024)和克罗恩病活动指数评分(β=-0.045,p<0.001)与SIBDQ评分呈负相关。共有202例患者在平均3.4年内完成了第二次SIBDQ。SIBDQ评分变化分布如下:降低>10%,占28%;-10%<变化<10%,占29%;升高>10%,占43%。在初始SIBDQ和随访SIBDQ中,与全身症状(紧张和疲劳)相关项目的评分相对较低。

结论

与排便相关的问题显著影响UC和CD患者的HRQoL。IBD患者在与总体健康相关的SIBDQ项目上得分较低。在IBD诊所随访3年后,43%的患者HRQoL有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fe7/11907260/1fad9595f807/gnl-19-2-236-f1.jpg

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