肺血栓栓塞症患者生活质量评估及影响因素

  目的  通过健康状况调查问卷SF-36量表评估肺血栓栓塞症(pulmonary thromboembolism，PTE)患者的生活质量并研究影响评分的相关因素。  方法  2016年5月至2017年11月在北京协和医院住院或呼吸内科门诊就诊的PTE患者受邀填写SF-36量表，并与中国普通人群比对。填写问卷的同时收集患者人口学资料(性别、年龄和肥胖状况)和临床资料[间隔时间(从诊断PTE时间至填表时间)、栓塞部位、深静脉血栓、癌症、慢性心肺疾病、诱发型PTE、一过性危险因素及永久性危险因素)，通过单因素及多因素线性回归分析明确这些变量与生活质量评分的相关性。  结果  88例符合入选排除标准的PTE患者完成SF-36量表并纳入最终分析。PTE患者SF-36量表各维度评分均低于中国普通人群:生理机能评分59.8±27.4比87.6±16.8，生理职能30.4±41.9比83.0±20.7，躯体疼痛67.4±23.6比83.3±19.7，一般健康状况43.0± 23.1比68.2±19.4，精力57.3±23.5比70.1±16.8，社会功能60.1±29.9比84.8±16.6，情感职能44.7±43.1比85.3±17.7，精神健康58.7±21.5比78.8±15.4，各维度比较均有统计学差异(P均＜0.01)。除精神健康这一变量外，PTE发生1年以上组各项生活质量评分均高于PTE发生1年内组。多因素线性回归分析显示，年龄和诱发型PTE与一般健康状况相关，间隔时间与躯体疼痛相关，一过性危险因素与生理机能、精力、社会功能及健康状况相关，而永久性危险因素则与精神健康相关。  结论  PTE患者生活质量低于普通人群，年龄、间隔时间、诱发型PTE、一过性危险因素和永久性危险因素与PTE患者生活质量相关。

Quality of Life in Patients with Pulmonary Thromboembolism and Its Determinants

  Objective  The aim of this study was to evaluate the quality of life in patients with pulmonary thromboembolism (PTE) by the SF-36 questionnaire and to investigate the determinants of the quality of life.  Methods  PTE patients who had discharged from Peking Union Medical College Hospital or had visited the Department of Respiratory Medicine between May 2016 and November 2017 were invited to fill the SF-36 question- naire. The  Results  were compared with the normal Chinese population. Demographic (gender, age, and obesity)and clinical data (the interval from PTE to questionnaire, locations of thrombus, deep vein thrombosis, cancer, chronic heart/pulmonary disease, provoked PTE, transient risk factor, and permanent risk factor) were collected and determinants were analyzed with the univariate and multivariate regression.  Results  Eighty-eight patients finished the SF-36 questionnaire. PTE patients had lower subscale scores of SF-36 compared with normal Chinese people: physical functioning, 59.8±27.4 vs. 87.6±16.8; role-physical, 30.4±41.9 vs. 83.0±20.7; bodily pain, 67.4±23.6 vs. 83.3±19.7; general health, 43.0±23.1 vs. 68.2±19.4; vitality, 57.3±23.5 vs. 70.1±16.8; social functioning, 60.1±29.9 vs. 84.8±16.6; role-emotional, 44.7±43.1 vs. 85.3±17.7; and mental health, 58.7±21.5 vs. 78.8±15.4 (all P < 0.01). The life quality scores of PTE that occurred more than one year before were higher than those of PTE within one year in every subscale except mental health. Multivariate regression analysis showed that: Age and provoked PTE were associated with general health; the interval from the diagnosis of PTE to questionnaire was associated with bodily pain; the transient risk factor was associated with role-physical, vitality, social functioning, health transition; and the permanent risk factor was associated with mental health.  Conclusions  The quality of life in PTE patients is generally lower than that in normal Chinese population; age, interval, provoked PTE, transient risk factor, and permanent risk factor are associated with their quality of life.