肠易激综合征患者生存质量的评价

目的　探讨与评价社区人群中肠易激综合征 (IBS)患者的健康相关生存质量 (HRQOL)情况。方法　在广东省采用分层、整群、随机抽样的调查中收集到的符合RomeⅡ诊断标准的 2 31例IBS患者 ,并随机选取 6 36例非IBS(NIBS)者为对照组 ;生存质量的调查采用世界卫生组织推荐的SF 36量表。结果　 (1)两组对象在年龄、性别、学历及城乡分布方面 ,经检验差异无显著性 (P >0 0 5 ) ;(2 )IBS组比NIBS组在生理机能、生理职能、情感职能、社会功能、躯体疼痛、精力、一般状况、精神健康、健康变化等各个维度分值均有明显降低 (P <0 0 5 ) ;IBS就诊者SF 36各个维度的分值比非就诊者有所降低 ,但差异无显著性 (P >0 0 5 ) ;(3)SF 36各维度分值与IBS患者每月犯腹痛的次数相关 (P <0 0 5 ) ;并与患者自诉腹痛对生活和工作的影响程度相关 (P <0 0 5 ) ;也与IBS患者是否出现乏力的症状相关 (P <0 0 5 ) ;(4)应对方式与HRQOL明显相关 ;控制应对方式对HRQOL的影响后 ,IBS组仍比NIBS组的HRQOL有明显下降。结论　与NIBS者相比 ,IBS患者生存质量明显下降 ;SF 36量表适用于IBS的HRQOL评估 ;但有必要进行有关IBS特异的生存质量量表的研究分析。

Evaluation of the quality of life of patients with irritable bowel syndrome

OBJECTIVE: To explore and assess the health-related quality of life (HRQOL) of irritable bowel syndrome (IBS) patients in the population. METHODS: Random clustered sampling involving permanent inhabitants aged 18 - 80 yr was carried out under stratification of urban and suburban areas in Guangdong Province. Altogether 231 IBS patients fulfilling the Rome II criteria and 636 Non-IBS as control were collected. The impact of IBS on HRQOL was evaluated using the Chinese version of SF-36. RESULTS: (1) There were no statistically significant differences between IBS and Non-IBS groups in aspects of sex, age educational level, and distribution according to areas (P > 0.05). (2) IBS patients reported significantly poorer HRQOL than controls (Non-IBS) on all SF-36 subscales (P < 0.05). The patients had poorer HRQOL than the Non-patients, but their differences weren't significant (P > 0.05). (3) The scores on all SF-36 subscales were highly associated with the frequency of abdominal pain in IBS patients (P < 0.05); They were also correlated to degree of effects of IBS symptoms on life reported by IBS patients (P < 0.05); The association between the scores and the symptom of fatigue which is the most extra-intestinal symptom in IBS was significant (P < 0.05); (4) Copying style was highly correlated to the eight SF-36 subscales; IBS still had a significant impact on patients after partialing out the effect of copying style. CONCLUSIONS: IBS symptoms had a negative impact on HRQOL and the SF-36 could be adopted to detect the differences between IBS group and Non-IBS group, which may be used as an outcome measure in future treatment studies. However, the development of IBS-specific measures of quality of life is necessary.