基于欧洲五维健康量表的冠状动脉粥样硬化性心脏病患者健康相关生命质量评价  

Evaluation of Health-related Quality of Life in Patients with Coronary Atherosclerosis Heart Disease Based on Eq-5d Scale

作　　者：赵帅 窦蕾 史钊[2,3] 付强 ZHAO Shuai;DOU Lei;SHI Zhao;FU Qiang(Department of Cardiovascular Surgery',TEDA International Cardiovascular Hospital,China Academy of Medical Sciences&Peking Union Medical College,Tianjin 300457,China;Center for Health Management and Policy,School of Public Health,Shandong University,Jinan 250012,China;National Health Commission Key Lab of Health Economics and Policy Research(Shandong University),Jinan 250012,China;Department of Cardiovascular Surgery,General Hospital of Tianjin Medical University,Tianjin 300052,China)

机构地区：[1]中国医学科学院北京协和医学院泰达国际心血管病医院心脏外科,天津300457 [2]山东大学公共卫生学院卫生管理与政策研究中心,济南250012 [3]国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),济南250012 [4]天津医科大学总医院心血管外科,天津300052

出　　处：《中国药物经济学》2021年第4期5-10,37,共7页China Journal of Pharmaceutical Economics

基　　金：国家卫生健康委员会卫生经济与政策研究重点实验室资助项目(NHC-HEPR2018003);天津市卫生健康委员会自筹项目(2011KZ114)。

摘　　要：目的评估冠状动脉粥样硬化性心脏病患者的健康相关生命质量,探讨生命质量的影响因素。方法选取2019年4—9月在天津医科大学总医院心内科运用欧洲五维健康量表(EQ-5D-5L)调查冠状动脉粥样硬化性心脏病的住院治疗患者,采用Kruskal-Wallis H检验进行组间比较,采用普通最小二乘法回归和Tobit回归进行生命质量影响因素分析。结果本研究调查了305例冠状动脉粥样硬化性心脏病住院患者,冠状动脉粥样硬化性心脏病患者在疼痛/不舒服和焦虑抑郁维度出现的问题最多,冠状动脉粥样硬化性心脏病患者健康效用值为0.847(95%CI:0.831~0.863);在不同类型的冠状动脉粥样硬化性心脏病患者中,稳定型心绞痛患者健康效用值为0.848(95%CI:0.810~0.885)、不稳定型心绞痛患者为0.844(95%CI:0.826~0.863)、陈旧性心肌梗死为0.956(95%CI:0.901~1.000)、急性心肌梗死患者为0.823(95%CI:0.742~0.905)。婚姻状况、文化程度、月收入、冠状动脉粥样硬化性心脏病类型、是否合并高血压、是否初次发病是生命质量的影响因素。结论冠状动脉粥样硬化性心脏病患者具有较低的生命质量,应关注冠状动脉粥样硬化性心脏病合并症、多次发病的患者。Objective To evaluate the health-related quality of life of patients with coronary atherosclerosis heart disease and to explore the influencing factors of the quality of life. Methods Patients with coronary atherosclerotic heart disease undergoing hospital treatment using the EQ-5 D-5 L survey from April 2019 to September 2019 in Department of Cardiology, General Hospital of Tianjin Medical University were selected. The Kruskal-Wallis H test was used for comparison different groups. Ordinary least square regression and Tobit regression were used to analyze the factors affecting the quality of life. Results The study investigated 305 patients with coronary atherosclerosis heart disease. The patients with coronary atherosclerosis heart disease had the most problems in the pain/discomfort and anxiety/depression dimensions. The health utility of patients with coronary atherosclerosis heart disease was 0.847(95% CI: 0.831, 0.863), Among patients with different types of coronary atherosclerotic heart disease, the health utility value of patients with stable angina pectoris was 0.848(95% CI: 0.810-0.885), and the value of patients with unstable angina was 0.844(95% CI: 0.826-0.863), old myocardial infarction was 0.956(95% CI: 0.901-1.000), and acute myocardial infarction was 0.823(95% CI: 0.742 to 0.905). Marital status, education level, monthly income, type of coronary atherosclerotic heart disease, whether combined with hypertension, and whether the first onset was the influencing factor of life quality. Conclusion Patients with coronary atherosclerotic heart disease have a lower quality of life, and we should pay attention to patients with coronary atherosclerotic heart disease complications and multiple attacks.

关 键 词：冠状动脉粥样硬化性心脏病 欧洲五维健康量表 健康相关生命质量 健康效用值 

分 类 号：R541.4[医药卫生—心血管疾病] R956[医药卫生—内科学]