摘要： 目的·探讨胃食管反流病（gastroesophageal reflux disease，GERD）对患者健康相关生活质量（health-related quality of life，HRQoL）的影响及相关影响因素。方法·对2019年5月至12月于上海交通大学医学院附属仁济医院消化内科门诊就诊的108例GERD患者进行欧洲五维健康量表（EuroQol 5-Dimensions Instrument with 5-Level Scale，EQ-5D-5L）调查以评估其HRQoL，并采用GERD-Q自测量表评估患者的临床症状，同时收集社会人口学与疾病相关信息以及医疗支出的数据。Fisher精确概率检验用于比较各个维度中有健康问题的患者数量和比例。采用单变量Tobit模型筛选与EQ-5D-5L效用值有相关性的影响因素，进一步采用普通最小二乘法（ordinary least squares，OLS）及Logistic回归模型探讨影响因素与HRQoL的关系。结果·108例患者中，EQ-5D-5L的平均效用值为0.855，标准差（standard deviation，
SD）为0.162。在体质量指数（body mass index，BMI；
P=0.000）、性别（
P=0.000）、内镜分级（
P=0.000）、GERD-Q得分（
P=0.049）、药物及医疗支出（
P=0.000）的亚组中，报告有健康问题的患者数差异具有统计学意义。在OLS回归模型中发现GERD-Q得分≥8分、治疗费用高对HRQoL有负面影响（均
P<0.05），而使用抗酸药有积极作用（
P<0.05）。在Logistic回归中，病程（
OR=1.222，
P=0.050）、使用抗酸药（
OR=10.808，
P=0.044）与HRQOL呈正相关。结论·GERD会降低患者的HRQoL，需要社会的支持及医疗决策者的关注。
关键词: 胃食管反流病, 欧洲五维健康量表（EQ-5D-5L）, 健康相关生活质量 Abstract: Objective·To evaluate the health-related quality of life (HRQoL) of patients with gastroesophageal reflux disease (GERD), and to explore the related factors.
Methods·EuroQol 5-Dimensions Instrument with 5-Level Scale (EQ-5D-5L) questionnaire was conducted on 108 GERD patients who visited the Gastroenterology Clinic of Renji Hospital, Shanghai Jiao Tong University School of Medicine from May to December 2019. GERD-Q questionnaire was used to assess their clinical symptoms. Other data including sociodemographic characteristics, disease-related information and medical costs were collected at the same time. Fisher's exact test was used to compare the amount and proportion of patients who had health problems in each dimension. The univariate Tobit model was used to select the influencing factors that were correlated with the EQ-5D-5L utility. Multivariate regression analysis such as the ordinary least squares (OLS) and Logistic regression model were employed to explore the factors affecting HRQoL of GERD patients.
Results·In the 108 patients, the average EQ-5D-5L utility score was 0.855 with a standard deviation (SD) of 0.162. In the subgroups of body mass index (BMI) (P=0.000), gender (P=0.000), endoscopy grade (P=0.000), GERD-Q score (P=0.049), medication and medical expenditures (P=0.000), the difference of proportion of patients who reported they had health problem were statistically significant. In OLS model, GERD-Q score greater than/equal to 8 and the higher medical expenditure had a negative impact on HRQoL (P<0.05), while use of antacids had a positive effect (P<0.05). Logistic regression analysis indicated that disease duration (OR=1.222, P=0.050) and use of antacids (OR=10.808, P=0.044) had positive relationship with HRQoL.
Conclusion·GERD could decrease the HRQoL of patients, and it requires the support and attention of medical decision-makers.
Key words: gastroesophageal reflux disease (GERD), EuroQol 5-Dimensions Instrument with 5-Level Scale (EQ-5D-5L), health-related quality of life (HRQoL) PDF全文下载地址:
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