结核病患者生存质量的测量与评价

目的评价结核病患者的生存质量，探讨影响结核病患者生存质量的因素，为制定改善结核病患者生存质量的合理治疗措施提供科学依据。方法采用SF-36及自制量表（QLI—TBV1．0）和自行设计的调查表对248例结核病患者和248例正常对照进行生存质量测量与评价并对收集影响因素资料进行单因素分析和多因素逐步回归分析。结果结核病患者的平均SF-36总评分及生理机能、角色生理状况、心理健康状况、角色心理状况、社会机能、活力、躯体疼痛和主观健康状况的平均评分（54±18、52±16、38±21、64±30、46±23、56±24、33±17、43±22、60±17）与对照组（81±14、78±20、75±19、80±12、68±11、77±18、85±20、70±17、85±10）相比差异有统计学意义（P〈0．01）；结核病患者的QLI—TB总分及生理功能、心理功能、社会功能、特异模块领域的平均评分（95±16、23±14、18±10、28±17、30±12）与对照组（151±14、42±18、25±8、39±23、42±14）相比差异有统计学意义（P〈0．01）；影响结核病患者生存质量的因素有年龄、性别、文化程度、经济水平、痰涂片结果、并发症等。结论QLI—TBV1．0可以用于我国结核病生存质量的初步测量，结核病患者生存质量全面低下，在治疗过程中应注意并发症的防治，提高其生存质量。

The measurement and evaluation of life quality of tuberculosis patients

Objective To measure and assess the quality of life （QOL） of tubereculosis patients using self- designed instrument and the influencing factors and provide scientific basis for prevention and control of the disease. Methods QOL of 248 tuberculosis patients and 248 healthy controls were assessed by self- designed instrument and SF - 36, information of influencing factors were collected by the questionnaire designed by the authore. Single and multiple stepwise regression analysis were made to evaluate factors affecting QOL of tuberculosis patients. Results The average total score of SF - 36, scores of physical functioning, role physical, mental health, role emotional, social functioning, vitality, bodily pain and general health were respectively 54 ±18, 52 ±16, 38 ±21, 64 ±30, 46 ±23, 56 ±24, 33 ± 17, 43 ±22 and 60 ± 17 in the tuberculosis group, while 81± 14, 78 ± 20, 75 ± 19, 80 ±12, 68±11,77 ± 18, 85 ± 20, 70± 17 and 85± 10 in the controls. Statistically significant differences were observed between the two groups （all P 〈 0.01 ）. The average total score of QLI - TB, scores of physical functioning, psychological functioning, social functioning and specific module were 95 ± 16, 23 ± 14, 18 ± 10, 28 ± 17 and 30 ± 12 in the tuberculosis group, while 151 ± 14, 42 ± 18, 25 ± 8, 39±23 and 42 ± 14 in the controls. Statistical- ly significant differences were found between the two groups（all P 〈 0.01 ）. The influencing factors were age, gender, literacy, economical situation, positive or negative smear and complications. Conclusion The QLI - TB V1.0 instrument is suitable for measurement of QOL of tuberculosis patients, the QOL of tuberculosis patients is low, so their complications must be prevented and treated for improving their QOL.