中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2009年
6期
514-521
,共8页
张秀兰%杜绍林%葛坚%陈伟蓉%樊倩%彭寿雄%余敏斌%刘杏
張秀蘭%杜紹林%葛堅%陳偉蓉%樊倩%彭壽雄%餘敏斌%劉杏
장수란%두소림%갈견%진위용%번천%팽수웅%여민빈%류행
青光眼%生活质量%疾病影响状态调查
青光眼%生活質量%疾病影響狀態調查
청광안%생활질량%질병영향상태조사
Glaucoma%Quality of life%Sickness impact profile
目的 应用儿童和青少年眼病生活质量量表评价原发性先天性青光眼患者的生活质量.方法 横断面研究.首先对5～20岁共51例原发性先天性青光眼术后患者和50例相匹配的正常对照者进行生活质量量表调查,并对量表的信度、效度及反应度进行评价;然后应用该量表对上述原发性先天性青光眼患者术后7年(中位数)末次随访时的生活质量状况进行量表调查.应用SPSS13.0统计学软件对数据进行处理.采用单因素相关分析和多因素逐步回归分析方法评价生活质量得分情况及其与疾病类型、病情严重程度、手术疗效、术后视力、年龄、性别、性格等关系.结果 量表共由23个条目组成,经评定具有较好的信度、效度及反应度;23个条目完全符合原发性先天性青光眼患者生活质量的评价要求.原发性先天性青光眼患者的生活质量量表总分60.02±10.02,比正常对照者的总分(71.41±10.11)明显偏低(t=5.682,P=0.000).单因素相关分析结果表明,病情严重程度(F=24.026,P=0.000)、手术疗效(t=2.638,P=0.009)及术后视力分级(F=11.248,P=0.000)均与生活质量总分相关,病情严重程度(F=12.677,P=0.000)和术后视力分级(F=10.369,P=0.000)与视功能领域得分相关,病情严重程度(F=11.064,P=0.000)和手术疗效(t=2.297,P=0.042)与自理能力领域得分相关;病情严重程度(F=6.869,P=0.020;F=5.721,P=0.019)和性格特征(t=4.352,P=0.009;t=2.297,P=0.042)均与活动交往和精神心理领域得分相关.多因素逐步回归分析结果表明,量表总分和患者病情严重程度(β=-6.985,P=0.001)、术后视力分级(β=-4.978,P=0.003)及性格(β=-5.201,P=0.020)之间均存在明显负相关.结论 该量表符合生活质量量表效度、信度、反应度及易于分析的技术要求,可以适用于5～20岁原发性先天性青光眼患者生活质量的临床研究.影响先天性青光眼患者生活质量的主要因素有病情严重程度、术后视力分级及性格特征.控制病情、提高视力、加强健康教育及心理指导是改善先天性青光眼患者术后生活质量的关键.
目的 應用兒童和青少年眼病生活質量量錶評價原髮性先天性青光眼患者的生活質量.方法 橫斷麵研究.首先對5～20歲共51例原髮性先天性青光眼術後患者和50例相匹配的正常對照者進行生活質量量錶調查,併對量錶的信度、效度及反應度進行評價;然後應用該量錶對上述原髮性先天性青光眼患者術後7年(中位數)末次隨訪時的生活質量狀況進行量錶調查.應用SPSS13.0統計學軟件對數據進行處理.採用單因素相關分析和多因素逐步迴歸分析方法評價生活質量得分情況及其與疾病類型、病情嚴重程度、手術療效、術後視力、年齡、性彆、性格等關繫.結果 量錶共由23箇條目組成,經評定具有較好的信度、效度及反應度;23箇條目完全符閤原髮性先天性青光眼患者生活質量的評價要求.原髮性先天性青光眼患者的生活質量量錶總分60.02±10.02,比正常對照者的總分(71.41±10.11)明顯偏低(t=5.682,P=0.000).單因素相關分析結果錶明,病情嚴重程度(F=24.026,P=0.000)、手術療效(t=2.638,P=0.009)及術後視力分級(F=11.248,P=0.000)均與生活質量總分相關,病情嚴重程度(F=12.677,P=0.000)和術後視力分級(F=10.369,P=0.000)與視功能領域得分相關,病情嚴重程度(F=11.064,P=0.000)和手術療效(t=2.297,P=0.042)與自理能力領域得分相關;病情嚴重程度(F=6.869,P=0.020;F=5.721,P=0.019)和性格特徵(t=4.352,P=0.009;t=2.297,P=0.042)均與活動交往和精神心理領域得分相關.多因素逐步迴歸分析結果錶明,量錶總分和患者病情嚴重程度(β=-6.985,P=0.001)、術後視力分級(β=-4.978,P=0.003)及性格(β=-5.201,P=0.020)之間均存在明顯負相關.結論 該量錶符閤生活質量量錶效度、信度、反應度及易于分析的技術要求,可以適用于5～20歲原髮性先天性青光眼患者生活質量的臨床研究.影響先天性青光眼患者生活質量的主要因素有病情嚴重程度、術後視力分級及性格特徵.控製病情、提高視力、加彊健康教育及心理指導是改善先天性青光眼患者術後生活質量的關鍵.
목적 응용인동화청소년안병생활질량량표평개원발성선천성청광안환자적생활질량.방법 횡단면연구.수선대5～20세공51례원발성선천성청광안술후환자화50례상필배적정상대조자진행생활질량량표조사,병대량표적신도、효도급반응도진행평개;연후응용해량표대상술원발성선천성청광안환자술후7년(중위수)말차수방시적생활질량상황진행량표조사.응용SPSS13.0통계학연건대수거진행처리.채용단인소상관분석화다인소축보회귀분석방법평개생활질량득분정황급기여질병류형、병정엄중정도、수술료효、술후시력、년령、성별、성격등관계.결과 량표공유23개조목조성,경평정구유교호적신도、효도급반응도;23개조목완전부합원발성선천성청광안환자생활질량적평개요구.원발성선천성청광안환자적생활질량량표총분60.02±10.02,비정상대조자적총분(71.41±10.11)명현편저(t=5.682,P=0.000).단인소상관분석결과표명,병정엄중정도(F=24.026,P=0.000)、수술료효(t=2.638,P=0.009)급술후시력분급(F=11.248,P=0.000)균여생활질량총분상관,병정엄중정도(F=12.677,P=0.000)화술후시력분급(F=10.369,P=0.000)여시공능영역득분상관,병정엄중정도(F=11.064,P=0.000)화수술료효(t=2.297,P=0.042)여자리능력영역득분상관;병정엄중정도(F=6.869,P=0.020;F=5.721,P=0.019)화성격특정(t=4.352,P=0.009;t=2.297,P=0.042)균여활동교왕화정신심리영역득분상관.다인소축보회귀분석결과표명,량표총분화환자병정엄중정도(β=-6.985,P=0.001)、술후시력분급(β=-4.978,P=0.003)급성격(β=-5.201,P=0.020)지간균존재명현부상관.결론 해량표부합생활질량량표효도、신도、반응도급역우분석적기술요구,가이괄용우5～20세원발성선천성청광안환자생활질량적림상연구.영향선천성청광안환자생활질량적주요인소유병정엄중정도、술후시력분급급성격특정.공제병정、제고시력、가강건강교육급심리지도시개선선천성청광안환자술후생활질량적관건.
Objective To evaluate the 23-item scale of Quality of Life (QOL) for patients with primary congenital glaucoma (PCG). Methods It was a cross-sectional study. The QOL scale specific for patients with PCG was firstly evaluated on 51 patients with PCG following antiglaucomat surgery at last follow-up visit (7.80 years±2.93 years with a median at 7 years) and 50 participants with normal visual acuity (VA) as control. All participants were aged 5-20 years old. The QOL of PCG was evaluated with type of disease, severity, surgical outcome, postoperative VA, age, gender and personality by using single-factor correlation analysis and multiple-factor stepwise regression analysis. Results The PCG-QOL scale achieved good reliability, validity and responsibility for PCG and 23-item were all qualified for QOL evaluation of PCG. The total scores of QOL in patients with PCG were significantly lower than those of normal individuals (PCG 60.22±10.02,normal individuals 71.41±10.11;t=5.682, P=0.000). Single-factor correlation analysis showed that the total scores of QOL were associated significantly with the severity of glaucoma (F=24.026, P=0.000), surgical outcome (t=2.638, P=0.009) and postoperative VA (F=11.248, P=0.000) ; The visual function scores were associated significantly with the severity (F=12.677, P=0. 000) and postoperative VA (F=10.369, P=0.000) ; The self-care ability scores were associated significantly with the severity (F=11.064, P=0.000) and surgical outcome (t=2.297, P=0.042) ; The social and mental scores were all correlated significantly with the severity (F=6.869, P=0.020; F=5.721, P=0.019) and personality (t=4.352, P=0.009 ; t=2.297, P=0.042). Multiple-factor stepwise regression analysis showed that there were significant correlations between total scores and the severity (β=-6.985, P=0.001 ), postoperative VA (β=-4.978, P=0.003 ) and personality (β=-5.201, P=0.020). Conclusions The PCG-QOL scale could be used for evaluating the QOL of PCG patients aged 5-20 years. The main factors that influence on the QOL of patients with PCG are severity of the disease, postoperative VA and personality. Preventing progression of glaucoma, improving VA and giving right psychological guidance may improve the QOL of patients with PCG.
