疾病特异性量表与普适性量表对支气管哮喘患者生命质量评估灵敏度的比较  

Comparison of responsiveness of asthma-specific and general instruments for evaluation of quality of life in patients with asthma

作　　者：李凡[1] 蔡映云[2] 徐晓雯[1] 李海玲[1] 韩志青[1] 罗艳蓉[1] 

机构地区：[1]上海交通大学附属新华医院分院杨浦区中心医院呼吸科,200090 [2]复旦大学附属中山医院

出　　处：《中华全科医师杂志》2006年第6期350-353,共4页Chinese Journal of General Practitioners

摘　　要：目的探讨疾病特异性量表与普适性量表对支气管哮喘患者生命质量评估的灵敏度。方法12个月非双盲定群研究,分别以5分制、7分制哮喘生命质量量表(5-AQLQ、7-AQLQ)和SF36量表对50例哮喘患者在初次、6个月和12个月时进行生命质量评估。随访期间每日监测呼气峰流速(PEF),并记录哮喘日记,根据支气管哮喘防治指南给予治疗,观察影响度和标准反应均数。结果经过12个月的治疗,50例支气管哮喘患者呼气峰流速占预计值的百分比从初次的51%,提高到6个月时的71%和12个月时的87%(P<0·01)。5-AQLQ和7-AQLQ总分分别从初次的3·35和4·3提高到6个月的4·03和5·6,12个月时的4·55和6·4(P<0·01);SF36总分从初次的410提高到6个月的494和12个月的640(P<0·01)。影响度和标准反应均数显示,5-AQLQ和7-AQLQ总分的影响度分别从0·84和0·91提高到1·39和1·52,标准反应均数分别从1·08和1·41提高到1·80和1·95,SF36总分的影响度从0·35提高到0·78,标准反应均数从0·42提高到1·22,均低于5-AQLQ和7-AQLQ总分的影响度和标准反应均数的变化。结论支气管哮喘生命质量量表和SF36均可反映支气管哮喘患者生命质量的变化,但支气管哮喘生命质量量表对患者生命质量的评估反应灵敏度比SF36量表高。Objective To compare the responsiveness of health status scores in asthmatic patients during treatment using asthma quality of life questionnaire （AQLQ） and medical outcomes study 36-item short form （SF36）. Methods In a 12-month non-double-masking cohort study, quality of life （QOL） was evaluated in 50 patients with bronchial asthma by AQLQ of five scores （5-AQLQ） and seven scores （7- AQLQ）, as well as SF36 at their initial visits and visits six months and 12 months after treatment. During the period of follow-up, their peak expiratory flow （PEF） was monitored every day and their asthma diaries were recorded. Patients underwent treatment with inhaled corticosteroids in accordance with the guidelines, and their effect size and standardized response mean were observed. Results The average PEF in 50 patients increased to 71% of the predicted values in 6-month and 87% in 12-month from 51% in initial visit （ P 〈0. 01 ）. Total scores increased to 4. 03 and 5.6 in 6-month and 4. 55 and 6. 4 in 12-month with 5- AQLQ and 7-AQLQ, respectively, from 3.35 and 4. 3 in initial visit, respectively （P 〈0. 01 ）. Total score of SF36 increased to 494 in 6-month and 640 in 12-month from 410 in initial visit （ P 〈0. 01 ）. Total scores of 5-AQLQ and 7-AQLQ as effect size increased to 1.39 and 1.52 from 0. 84 and 0. 91, respectively, and those as standardized response mean increased to 1.80 and 1.95 from 1.08 and 1.41, respectively. Total score of SF36 as effect size increased to 0. 78 from 0. 35 and that as standardized response mean increased to 1.22 from 0. 42, respectively. All changes of scores of SF36 were lower than those of 5-AQLQ and 7-AQLQ. Coefficient of correlation between total scores of AQLQ and PEF as percentage of the predicted measures was significantly more than that between total scores of SF36 and PEF. Conclusion Evidence from this study showed both AQLQ and SF36 could be used to detect changes in QOL of patients with asthma, but more responsive with AQLQ.

关 键 词：哮喘 生活质量 量表 

分 类 号：R562.25[医药卫生—呼吸系统]