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目的对比观察36条简明健康状况调查表(SF-36)与明尼苏达州心力衰竭生活质量问卷(MLHFQ)在慢型克山病患者生活质量评价中的作用。方法依据《克山病诊断》(WS/T 210-2011)标准,选择符合入选条件的慢型克山病患者146例,采用中文版SF-36及MLHFQ分别对受检者HRQOL进行问卷调查,并应用相关分析、多元线性回归对两个问卷评分的相关性及患者HRQOL的影响因素进行分析探讨。结果 (1)相关分析显示,MLHFQ得分与SF-36总分、心理健康内容、生理健康内容的得分呈高度负相关(r=-0.776、-0.750、-0.733,P均<0.01))。(2)不同NYHA心功能级别的慢型克山病患者HRQOL相比较,MLHFQ和SF-36在心功能Ⅲ级与心功能Ⅱ级的患者间相比较有统计学意义(P<0.01),在Ⅳ级与Ⅲ级间相比较无差异(P>0.05)。(3)多元逐步回归分析显示,影响慢型克山病患者MLHFQ总分及SF-36总分的主要因素为NYHA心功能分级、病程,对MLHFQ总分及其各领域得分、SF-36总分及其不同方面得分均有影响的因素为NYHA心功能分级。结论 (1)慢型克山病患者SF-36与MLHFQ的得分具有良好的相关性。(2)SF-36及MLHFQ在区别慢性克山病患者中具有轻度心力衰竭患者的生存质量方面具有重要的作用。(3)NYHA心功能分级和病程是影响慢型克山病患者生存质量的重要因素。(4)SF-36用于慢型克山病患者生存质量的评价具有重要的参考价值。
Objective To compare the effects of 36 simple health status questionnaires (SF-36) and Minnesota Heart Failure Quality of Life Questionnaire (MLHFQ) on quality of life assessment of patients with chronic Keshan disease. Methods Based on the criteria of Keshan Disease Diagnosis (WS / T 210-2011), 146 cases of chronic Keshan disease were selected according to the inclusion criteria. The Chinese version SF-36 and MLHFQ were used to survey the subjects’ HRQOL. Correlation analysis and multivariate linear regression were used to analyze the correlation between the two questionnaires and the influencing factors of HRQOL. Results (1) The correlation analysis showed that the score of MLHFQ was negatively correlated with the score of SF-36 total score, mental health content and physical health content (r = -0.776, -0.750, -0.733, P <0.01). (2) Compared with HRQOL in chronic Keshan disease patients with NYHA functional class, MLHFQ and SF-36 were statistically significant (P <0.01) in patients with cardiac function grade III and cardiac function grade II, There was no difference between grade Ⅲ and grade Ⅲ (P> 0.05). (3) Multivariate stepwise regression analysis showed that the main factors affecting the total score of MLHFQ and SF-36 in patients with chronic Keshan disease were NYHA functional classification, course of disease, total score of MLHFQ and its scores in all fields, SF-36 total Points and their different aspects of the factors that have an impact on NYHA functional classification. Conclusion (1) There is a good correlation between SF-36 and MLHFQ scores in patients with chronic Keshan disease. (2) SF-36 and MLHFQ play an important role in differentiating the quality of life of patients with mild heart failure in patients with chronic Keshan disease. (3) NYHA cardiac function classification and course of disease is an important factor affecting the quality of life of patients with chronic Keshan disease. (4) SF-36 for the evaluation of the quality of life of patients with chronic Keshan disease has an important reference value.