Impairment of health-related quality of life in functional dyspepsia and chronic liver disease:: the influence of depression and anxiety
Impairment of health-related quality of life in functional dyspepsia and chronic liver disease:: the influence of depression and anxiety
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DOI：
10.1111/j.1365-2036.2008.03619.x
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发表时间：
2008-04-01
影响因子：
7.6
通讯作者：
Holtmann, G.
中科院分区：
文献类型：
--
作者：
Haag, S.;Senf, W.;Holtmann, G.
背景：健康相关生活质量（HRQOL）是疾病严重程度的标志。关于慢性肝病（CLD）和功能性胃肠疾病患者HRQOL相对受损的数据缺乏，也没有研究评估HRQOL受损与社会心理因素之间的联系。目的探讨CLD和FD患者HRQOL的预测因素及影响因素。方法对181例功能性消化不良（FD）患者、204例慢性消化不良（CLD）患者和337名健康献血者采用短表36（精神和身体部分）评估HRQOL，采用医院焦虑抑郁量表评估焦虑和抑郁。结果与HC相比，FD和CLD患者的HRQOL显著降低（p值均< 0.001）。与CLD相比，FD患者HRQOL的精神部分明显受损，而身体部分明显受损（P < 0.05）。在调整混杂因素后，HRQOL的精神（P < 0.001）和身体（P = 0.005）部分的损害与CLD和FD的严重程度相关。在FD中，多因素分析显示抑郁和症状严重程度是HRQOL最重要的预测因素（R-2 = 21.9和7.1）。在CLD中，HRQOL的精神成分与抑郁和焦虑相关（R-2 = 9.9和9.7）。结论在三级保健中，FD患者的HRQOL比CLD患者更严重。共病性精神疾病对HRQOL的损害有显著影响。
Background Health-related quality of life (HRQOL) is a marker of disease severity. Data on the relative impairment of HRQOL in chronic liver disease (CLD) and functional gastrointestinal disorders are lacking and no studies have assessed the link between impairment of HRQOL and psychosocial factors yet.Aim To assess predictors for, and the impairment of, HRQOL in CLD and FD.Methods In 181 functional dyspepsia (FD) patients, 204 CLD patients and 337 healthy blood donors, HRQOL was assessed with the Short Form-36 (mental and physical component), and anxiety and depression utilizing the Hospital Anxiety and Depression Scale.Results Compared with HC, HRQOL is significantly lower in FD and CLD (P-value for all < 0.001). The mental but not physical component of HRQOL was significantly more impaired in FD compared with CLD (P < 0.05). After adjusting for confounders, impairment of mental (P < 0.001) and physical (P = 0.005) component of HRQOL was associated with the severity of CLD and FD. In FD, the multivariate analysis revealed depression and severity of symptoms as the most important predictors of HRQOL (R-2 = 21.9 and 7.1). In CLD, the mental component of HRQOL was associated with depression and anxiety (R-2 = 9.9 and 9.7).Conclusions In tertiary care, HRQOL is more severely impaired in FD compared with CLD. Co-morbid psychiatric conditions significantly contribute to the impairment of HRQOL.