高血压患者健康相关生存质量的评价研究  

Health related quality of life in hypertensive patients

作　　者：王家良[1] 康德英[1] 洪旗 廖晓阳[1] 尹国玲 张兰 章茂顺[1] 符宗胤 

机构地区：[1]华西医科大学第一附属医院临床流行病学教研室,成都610041 [2]四川工学院校医院 [3]成都理工学院校医院 [4]四川省教育委员会

出　　处：《中华医学杂志》1999年第8期599-602,共4页National Medical Journal of China

基　　金：四川省科委基金

摘　　要：目的　探讨与评价高血压患者的健康相关生存质量（ Ｈ Ｒ Ｑ Ｏ Ｌ） ，为全面评价抗高血压治疗效果提供相应的依据。方法　应用 Ｓ Ｆ３６ 生存质量量表对１０６ 例高血压患者及１２７ 名正常血压者进行了同期的横断面调查与比较，并用受试者特征曲线（ Ｒ Ｏ Ｃ 法） 确定 Ｈ Ｒ Ｑ Ｏ Ｌ 最佳诊断参考值。此外，对其中适宜抗高血压药物治疗的６０ 例高血压患者，采用自身前后对照设计，经６ 个月治疗后，分析比较了 Ｈ Ｒ Ｑ Ｏ Ｌ与治疗效果之间的关系。结果　（１） 除了生理功能及疼痛感外，高血压患者有关生理、心理、社会功能的其余７ 大项指标均较正常血压对照组减低，差异有显著意义（ Ｐ＜ ００５ ～＜０００１） ；（２） 本研究的 Ｈ Ｒ Ｑ Ｏ Ｌ正常判断参考值为２９０ 分，其敏感性８０ ％ ，特异性７０ ％ ；（３）６０ 例高血压患者经６ 个月治疗后，药物治疗有效率为６３ ％ ，而 Ｈ Ｒ Ｑ Ｏ Ｌ 改善率为７５ ％ 。结论　高血压患者的健康相关生存质量显著低于正常血压者； Ｈ Ｒ Ｑ Ｏ Ｌ测试有利于对高血压患者治疗效果的综合评价。Objectives To explore the health related quality of life (HRQOL) for hypertensive patients (HBP) and to provide reasonable evidence for evaluating the effectiveness of antihypertensive therapy in clinical practice Methods A cross sectional study was used to survey 106 patients with HBP and 127 normotensives using SF 36 short form of quality of life in the community The cutoff point score of HRQOL was decided by receiver operating characteristic (ROC) Curve analysis There were 60 patients with BP≥160/95 mm Hg who had been treated by antihypertensive drugs for 6 months Before and after the treatment, their HRQOL was measured and evaluated, and the relationship between the change of HRQOL and antihypertensive effect was evaluated Results Apart from physical function and pain, other 7 domains were significantly lower in the hypertensive group than in the normotensive group, which included social function, role limitations attributed to both physical and emotional problems, mental health, activity or fatigue and overall evaluation of health ( P <0 05～0 001) A cutoff point of HRQOL was decided using ROC analysis in which the 290 score was the best one for diagnostic HRQOL with the sensitivity of 80% and a specificity of 70% The target rate of the antihypertensive care and the improved rate of HRQOL for 60 patients with HBP were 63% and 75% separately for a 6 month treatment Conclusion The HRQOL of these hypertensives was significantly lower than that in the normotensives in the study The measurement of HRQOL was more useful to evaluate the antihypertensive effectiveness in clinical practice

关 键 词：高血压 健康 生活质量 评价研究 

分 类 号：R544.1[医药卫生—心血管疾病]