恶性淋巴瘤患者生存质量影响因素研究

目的测量和评价恶性淋巴瘤患者的生存质量,探讨其影响因素.方法采用中文并经心理测量学考评的EORTC QLQ-C30量表,对110例恶性淋巴瘤患者进行生存质量测量和评价,采用SPSS 12.0软件对数据进行统计学分析,对所有数据进行正态性检验,对所有可能的影响患者生存质量的因素,根据资料的性质采用方差分析或Kruskal-Wallis检验,Spearman相关进行单因素分析;分别以5个功能维度得分、功能领域总得分和总量表得分为因变量,以单因素分析结果P≤2.0的影响因素为自变量进行多元逐步回归分析,筛选出影响恶性淋巴瘤患者生存质量的主要因素.结果影响生存质量总分因素为复发（偏回归系数β=5.997,P=0.020）和戒烟（β=-6.526,P=0.006）,影响功能领域总分的因素为文化程度（β=-2.144,P=0.057）和复发（β=5.857,P=0.003）;影响躯体功能的因素为康复锻炼（β=-0.771,P=0.097）和戒烟（β=-4.106,P=0.005）,影响角色功能的因素为戒烟（β=-4.644,P=0.008）和年龄（β=0.989,P=0.029）;影响认知功能的因素为年龄（β=2.230,P=0.023）和复发（β=14.035,P=0.001）;影响情绪功能的因素为人均居住面积（β=-3.054,P=0.0901）和复发（β=8.500,P=0.031）,影响社会功能的因素为医疗形式（β=-6.577,P=0.018）.结论正确认识恶性淋巴瘤,坚定生活信念,纠正不良的生活习惯和加强康复锻炼,以及拥有和睦的家庭环境、必要的社会福利保证等方面可促进其各项功能的康复,防止恶性淋巴瘤的复发,从而全面提高生存质量.

Study on the factors influencing the quality of life among patients with malignant lymphoma

OBJECTIVE: To measure and assess the quality of life (QOL) and to explore the influencing factors on patients with malignant lymphoma. METHODS: QOL of 110 patients with malignant lymphoma were marked using EORTC QLQ-C30 short form, and multiple linear regression models were used to study the main factors influencing the QOL of patients with malignant lymphoma on five functional scales (physical, role, cognitive, emotional, and social) and the total scores. RESULTS: The influencing factors of quality of life on patients with malignant lymphoma appeared to be: history of relapse, refraining from smoking, older age, educational level, space for living, exercises, medical care system, and available health care programs. Relapse (beta = 5.997, P= 0.020) and refraining from smoking (beta = -6.526, P= 0.006) were associated with total QOL scores, educational level (beta = -2.144, P= 0.057), History of relapse (beta = 5.857, P = 0.003) was associated with total functional scales while exercises (beta= -0.771, P = 0.097) and refraining from smoking (beta= -4.106, P = 0.005) were with physical scales, refraining from smoking (beta = -4.644,P = 0.008) and older age (beta = 0.989, P= 0.029) were with role scales, relapse (beta = 14.035, P= 0.001) and older age (beta = 2.230, P= 0.023) were with cognitive scales, relapse (beta = 8.500, P= 0.031) and living space (beta = - 3.054, P= 0.0901) were with emotional scales and medical care system and available health care programs (beta = -6.577, P= 0.018) were with social scales respectively. CONCLUSION: Factors as prevention of relapse, correct cognition on malignant lymphoma, reasonable exercise, refrain from bad habits, improving medical care system could all increase the functions of malignant lymphoma patient, and to improve their quality of life.