摘要：

目的·探討胃食管反流?。╣astroesophageal reflux disease，GERD）對(duì)患者健康相關(guān)生活質(zhì)量（health-related quality of life，HRQoL）的影響及相關(guān)影響因素。方法·對(duì)2019年5月至12月于上海交通大學(xué)醫(yī)學(xué)院附屬仁濟(jì)醫(yī)院消化內(nèi)科門(mén)診就診的108例GERD患者進(jìn)行歐洲五維健康量表（EuroQol 5-Dimensions Instrument with 5-Level Scale，EQ-5D-5L）調(diào)查以評(píng)估其HRQoL，并采用GERD-Q自測(cè)量表評(píng)估患者的臨床癥狀，同時(shí)收集社會(huì)人口學(xué)與疾病相關(guān)信息以及醫(yī)療支出的數(shù)據(jù)。Fisher精確概率檢驗(yàn)用于比較各個(gè)維度中有健康問(wèn)題的患者數(shù)量和比例。采用單變量Tobit模型篩選與EQ-5D-5L效用值有相關(guān)性的影響因素，進(jìn)一步采用普通最小二乘法（ordinary least squares，OLS）及Logistic回歸模型探討影響因素與HRQoL的關(guān)系。結(jié)果·108例患者中，EQ-5D-5L的平均效用值為0.855，標(biāo)準(zhǔn)差（standard deviation，SD）為0.162。在體質(zhì)量指數(shù)（body mass index，BMI；P=0.000）、性別（P=0.000）、內(nèi)鏡分級(jí)（P=0.000）、GERD-Q得分（P=0.049）、藥物及醫(yī)療支出（P=0.000）的亞組中，報(bào)告有健康問(wèn)題的患者數(shù)差異具有統(tǒng)計(jì)學(xué)意義。在OLS回歸模型中發(fā)現(xiàn)GERD-Q得分≥8分、治療費(fèi)用高對(duì)HRQoL有負(fù)面影響（均P<0.05），而使用抗酸藥有積極作用（P<0.05）。在Logistic回歸中，病程（OR=1.222，P=0.050）、使用抗酸藥（OR=10.808，P=0.044）與HRQOL呈正相關(guān)。結(jié)論·GERD會(huì)降低患者的HRQoL，需要社會(huì)的支持及醫(yī)療決策者的關(guān)注。

關(guān)鍵詞: 胃食管反流病, 歐洲五維健康量表（EQ-5D-5L）, 健康相關(guān)生活質(zhì)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)

中圖分類號(hào): 

R573.9

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