耐多药肺结核患者生命质量的评价

目的 从生命质量的角度评价耐多药肺结核(MDR-TB)患者的健康状况及变化。方法用SF-36量表对100例MDR-TB患者和100名正常人进行生命质量测评,对完成疗程92例患者治疗前、治疗3个月及治疗1年的生命质量总评分及各维度得分进行配对t检验、多元方差分析评价疗效。对生命质量的影响因素进行单因素分析和多因素逐步回归分析。结果MDR-TB患者的生命质量总分及8个维度得分与正常对照组相比有显著性差异(P<0.01);治疗3个月或治疗1年的生命质量总分及8个维度的得分明显高于治疗前且有显著性差异(P<0.01);治疗1年后的总分及PF、PR、GH、VT、SF、ER、MH 7个维度较对照组低并有显著性差异(P<0.05)。影响MDR-TB患者生命质量的主要因素是:文化程度、耐药数目、WBC降低。结论MDR-TB患者的Qol均显著降低,治疗后生命质量明显提高,但治疗1年后仍不能恢复正常。早期强化期治疗能够明显提高MDR-TB患者的Qol。影响MDR-TB患者生命质量的主要因素是:文化程度、耐药数目、WBC降低。

Evaluating the quality of life of patients with multi-drug resistant pulmonary tuberculosis

Objective To evaluate health and curative effect of patients with multi-drug resistant pulmonary tuberculosis(MDR-TB) from the angle of the quality of life(Qol). Methods To measure and evaluate Qol for 100 patients with MDR-TB and 100 natural persons using SF-36 instrument.To state and accomplish 92 patients Qol.The investigation time was before,3 months after treatment and 1 year after treatment.The changes of Qol scores were evaluated in total and many domains To evaluate curative effect using paired t test and analysis of variance.Single and multiple stepwise regression analysis were made to evaluate factors affecting Qol. Results Between the patients with MDR-TB and the control in the total Qol scores and eight domains,there were significant differences(P<0.01),total Qol scores and eight domains in 3 months or 1 year after treatment were higher than before therapy,there were significant differences(P<0.01).Between 1 year after therapy in the total Qol scores and PF、 PR、GH、 VT、 SF、 ER、 MH’s domains were lower than control groups,there were significant differences(P<0.05).The main factors affecting the Qol of patients with MDR-TB were cultural level,kinds of drug resistant and reduction of counts of white blood cell. Conclusion There were comprehensive reduces in the quality of life of patients with MDR-TB. The quality of life of patients with MDR-TB had increased significantly but hadn’t recovered completely 1 year after therapy.Early intensive therapy could increase the quality of life of patients with MDR-TB.The main factors affecting the Qol of patients with MDR-TB are cultural level,kinds of drug resistant and reduction of counts of white blood cell.