绝经后骨质疏松患者生活质量的影响因素研究及其经济学评价  

Factors to the quality of life of postmenopausal osteoporosis patients and economic evaluation

作　　者：胡宇峰[1] 孙振球[1] 冯铁建[2] 许林勇[1] 

机构地区：[1]中南大学公共卫生学院,湖南长沙410078 [2]深圳市慢性病防治中心,广东深圳518020

出　　处：《中国现代医学杂志》2010年第7期1050-1054,共5页China Journal of Modern Medicine

基　　金：国家"十五"科技攻关项目<老年疾病医疗后果评价系统的研究>资助项目(No:2001BA702B04)

摘　　要：目的探讨影响绝经后骨质疏松患者生活质量的影响因素并利用生活质量指标进行几种常见治疗方案经济学评价,为挑选治疗方案提供参考。方法将188例确诊为绝经后骨质疏松症的患者分为4组,其中安慰剂对照组38例,维生素D加钙治疗组50例,雌激素替代疗法(hormone replacement treatment,HRT)组50例,二膦酸盐治疗组50例。重复测量治疗前、治疗后3个月和治疗后12个月的骨密度(bone mineral density,BMD),生活质量评分(QualityofLifeSale,QOLS),影响因素调查以及花费成本。分析生活质量的因素因素并比较各组之间单位生活质量改变率和单位骨密度改变率的成本。结果二膦酸盐治疗组生活质量改善较好,牛奶摄入量越多的患者疾病维度评分增长越快,那些吸烟、喝酒的患者,生活质量评分增长较慢,以前有骨折史的患者,生活质量增长也较慢,而基线疾病维度评分较高的患者和体重指数较高的患者,生活质量增长较快。适量体力活动的患者比不活动的患者生活质量改善要好。二膦酸盐治疗组单位生活质量改变率和单位骨密度改变率的成本(分别为38.78、57.10和85.39元)明显低于其他组,但用维生素D加钙组治疗没有明显效果。结论二膦酸盐治疗组不仅有利于骨质疏松患者生活质量的改善而且有比较好的成本效果,是一种经济有效的治疗绝经后骨质疏松的手段。【Objective】To explore the factors of the quality of life of postmenopausal osteoporosis patients and apply the quality of life to the economic evaluation of treatment programs,provide a reference for the selection of treatment options.【Method】188 cases of patients diagnosed as PMOP divided into four groups,including placebo control group（38 cases）,vitamin D plus calcium treatment group（50 cases）,hormone replacement treatment（HRT） group（50 cases）,and two phosphonic acid salt treatment group（50 cases）.Repeated measured the bone mineral density（BMD）,Quality of Life Sale（QOLS）,the factors of the QOLS and the cost of investigation and treatment before treatment,after 3 months treatment and after 12 months treatment.Analyzed the factors of the quality of life and compared the unit cost of the rate change of the quality of life between the 4 groups and the unit cost of the rate change of bone mineral density changes.【Result】Improved quality of life better in the two bisphosphonate treatment group,milk intake,the more sale of the dimensions of disease before treatment and the more BMI in patients,the QOLS grows faster.The QOLS of those who smoke or/and drink increased more slowly,and the QOLS of those who had history of a fracture patients increased more slowly also,while the QOLS of those who apply the moderate physical activity increased faster than non-activity.The unit cost of the rate change of the quality of life between the 4 groups and the unit cost of the rate change of bone mineral density changes（$38.78,$57.10,$85.39） in bisphosphonate treatment group was significantly lower than other groups,but there is no apparent effect in vitamin D plus calcium group.【Conclusion】 The two bisphosphonate treatment group will not only help osteoporosis patients to improve the quality of life and have a better cost-effectiveness,it is a cost-effective treatment for postmenopausal osteoporosis means.

关 键 词：生活质量 绝经后骨质疏松症 经济学评价 

分 类 号：R681[医药卫生—骨科学]