基于欧洲五维度五水平健康量表评估难治性继发甲状旁腺功能亢进患者生命质量  

Evaluation of the quality of life in patients with refractory secondary hyperparathyroidism based on the EQ-5D-5L scale

作　　者：杨柳 张凌[2] 杨猛[3] 杨莉[1,4] YANG Liu;ZHANG Ling;YANG Meng;YANG Li(Department of Health Policy and Management,School of Public Health,Peking University,Beijing 100191,China;Department of Nephrology,China-Japan Friendship Hospital,Beijing 100029,China;Department of General Surgery,China-Japan Friendship Hospital,Beijing 100029,China;Center for Health Policy and Technology Evaluation,Peking University Health Science Center,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院卫生政策与管理学系,北京100191 [2]中日友好医院肾病科血液净化中心,北京100029 [3]中日友好医院普外科,北京100029 [4]北京大学医学部卫生政策与技术评估中心,北京100191

出　　处：《中国血液净化》2021年第11期742-745,共4页Chinese Journal of Blood Purification

基　　金：国家自然科学基金(71273016,71673004,71911530221);北京市科技计划课题(Z151100004015112)。

摘　　要：目的采用欧洲五维度五水平健康量表(five-level EuroQol five-dimensional questionnaire,EQ-5D-5L)测量血液透析并发难治性继发甲状旁腺功能亢进症(secondary hyperparathyroidism,SHPT)患者的健康效用值,评价患者的生命质量及相关影响因素。方法采用EQ-5D-5L量表调查北京中日友好医院150例接受手术和拟钙剂西那卡塞药物治疗的SHPT患者,从多个维度评价患者的生命质量,计算健康效用值,采用多元回归分析相关影响因素。结果共回收有效问卷144份,年龄(48.17±10.95)岁,健康效用值0.89(0.78,1.0),视觉刻度尺(visual analogue scale,VAS)得分80(62.5,90.0)分。66.1%患者存在不同程度的疼痛或不舒服,自我照顾方面86.3%患者不存在任何困难。回归分析结果提示治疗方式、全段甲状旁腺激素(iPTH)水平和年龄对结果有影响,药物治疗组的健康效用值较高(β值分别为0.231、-0.176、-0.188,P值分别为0.039、0.007、0.049)。结论接受治疗的难治性SHPT患者总体生命质量较好,但疼痛和不舒服以及心理问题还是比较严重,应得到重视。换算的效用值可为疾病相关经济学研究提供数据支持。Objective To use the Five-level EuroQol Five-dimensional Questionnaire(EQ-5D-5L)scale to measure the health utility value and to evaluate the quality of life and its related influencing factors in hemodialysis patients complicated with refractory secondary hyperparathyroidism(SHPT).Methods The ED-5Q-5L scale was used to evaluate the quality of life from multiple dimensions and to calculate the health utility values in a total of 150 hemodialysis patients with SHPT who received surgery and cinacalcet in China-Japan Friendship Hospital in Beijing.Multivariate regression analysis was used to analyze the related influencing factors.Results A total of 144 valid questionnaires were collected.The patients had an average age of 48.17±10.95 years.The overall health utility value was 0.84±0.19,and the visual analogue scale(VAS)score was 80(62.5,90.0).Various degrees of pain or discomfort were present in 66.1%patients,and no difficulties in self-care were found in 86.3%patients.Regression analysis showed that treatment method,intact parathyroid hormone(iPTH)level and age impacted on the results.Patients in drug treatment group had higher health utility values(β=0.231,-0.176 and-0.188 respectively,P=0.039,0.007 and 0.049 respectively).Conclusion The overall quality of life was improved in treated patients with refractory SHPT.However,pain,discomfort and psychological disorders are still problematic and should be taken into consideration.The data of converted utility value can be used to support the disease-related economic research.

关 键 词：欧洲五维度五水平健康 健康效用值 甲状旁腺功能亢进 甲状旁腺切除术 维持性血液透析 

分 类 号：R473[医药卫生—护理学]