Graves病患者^131I治疗后疾病影响程度与生活质量变化  

The sickness impact and the quality of life in Grave＆#39;s disease patients after treatment with 131I

作　　者：张海三[1,2] 张红星[1,2] 刘保平[3] 

机构地区：[1]郑州大学第一附属医院核医学科,郑州450000 [2]新乡医学院第二附属医院心理学系 [3]郑州大学第一附属医院心理学系,郑州450000

出　　处：《中华行为医学与脑科学杂志》2014年第10期904-908,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：河南省重点科技攻关项目（092102310273）

摘　　要：目的 探讨Graves病（GD）患者在接受131I治疗一年后疾病影响程度及生活质量状况.方法 纳入GD患者376例.患者自愿接受131I治疗,建立随访档案,分别在接受131I治疗前、治疗后第6月、12月采用疾病影响程度量表（SIP）、焦虑自评量表（SAS）、抑郁自评量表（SDS）、社会功能缺陷筛查量表（SDSS）及生活质量问卷（QLS）进行评估.结果 失访57例,319例完成随访.131I治疗前、治疗后6月及12月各量表总分及因子分均数差异存在统计学意义,治疗后SAS、SDS、SDSS、SIP总分及各因子分评分降低（F=8.561 ～ 1080.317,P＜0.001）,SF-36量表总分与各因子分均较治疗前有所升高（P＜0.05）.治疗后12月与6月相比,SAS、SDS、SDSS、SIP总分、SIP因子分SD-Ⅱ、SR、W与SF-36因子分RP、BP、VT、SF差异无统计学意义（P＞0.05）;SIP因子分SD-Ⅰ、HM、RP与SF-36总分及因子分PF、GH、RE、MH差异有统计学意义（P＜0.05）,SIP因子分SD-Ⅰ、HM、RP较6月时高（P＜0.05）,而SF-36总分及因子分PF、GH、RE、MH较6月时低 （P＜0.05）;治疗后6月、12月时不同临床结局组各量表总分及SIP因子分SD-Ⅰ、SD-Ⅱ、SR、W、RP与SF-36因子分PF、RP、BP、GH、VT、SF、RE、MH差异均有统计学意义（F6=6.870～143.79,F12=13.956～837.184,P＜0.001）,SIP量表HM因子分在6月与12月时均差异无统计学意义（F6=1.733,P6=0.142;F12=2.015,P12=0.092）.治疗后6月与12月时甲状腺功能正常组与健康对照组相比,SF-36总分及因子分PF、RP、VT、SF、RE、MH仍差异有统计学意义（F=8.320～ 82.791,P≤0.001）;因子分BP、GH比较差异无统计学意义（F=2.990、2.652,P=0.051、0.072）.结论 GD患者生活质量严重下降,131I治疗可以改善患者总体生活质量,但社会心理状况改善并不理想,关注GD患者生活质量,提供有效的心理干预是提高GD患者愈后的重要措施.Objective To evaluate the sickness impact and the quality of life in patients who received 131 I treatment for Grave＆#39;s disease with one year of follow-up.Methods 376 patients with Grave＆#39;s disease（GD） who voluntarily received 131I treatment were recruited.The follow-up archives were established.The Sickness Impact and the Quality of life in patient＆#39; s with GD were measured using the Sickness Impact Profile （SIP）,Self-Rating Anxiety Scale （SAS）,Self-Rating Depression Scale（SAS） and Social Disability Screening Schedule （SDSS） and Quality of life scale（QLS,SF-36） before and after treatment with 131I for 6 months and 12 months.Results 57 out of 376 cases were lost.319 cases finished follow-up studies.There was significant difference of SAS,SDS,SDSS,SIP and SF-36 and their agent score among three groups：before and 6months and 12months after 131I treatment in the 319 patients（F=8.561-1080.317,P〈0.001）.After treatment with 131I,SAS,SDS,SDSS and SIP score were lower（P〈0.05）,SF-36 total and agent score were higher（P〈0.05）.There was no significant difference between the score of SAS,SDS,SDSS,SIP total score and it＆#39; s agent score of SD-Ⅱ,SR,W,SF-36 agent score of RP,BP,VT,SF at the end of 12 months compared to the score at the end of 6 months（P〉0.05）.But there was significant difference between the score of SIP agent score of SD-Ⅰ,HM,RP,SF-36 total score and it＆#39; s agent score of PF,GH,RE,M H at the end of 12 months compared to the score at the end of 6 months （P〈0.05）.At the end of 6 months and 12 months after treatment the subjects were divided five groups according to different clinical outcome.Not only at the end of 6 months,but also at the end of 12 months,there was significant difference of SAS,SDS,SDSS,SIP total score,and it＆#39; s agent score of SD-Ⅰ,SD-Ⅱ,SR,W,RP,SF-36 total score,and it＆#39;s agent score PF,RP,BP,GH,VT,SF,RE,MH among the five groups（F6 =6.870-143.790,F12 =13.956-837.184,P〈0.001）.There was no signif

关 键 词：GRAVES病 131-碘 心理健康 生活质量 

分 类 号：R581.1[医药卫生—内分泌]