CAJ | 학술논문

背景近年来关于青光眼对患者生活质量的影响日益受到临床工作者的关注，但调查结果表明各种视功能量表均存在一定的不足，准确、全面地评价影响青光眼患者生活质量的主观和客观因素值得深入研究。目的利用效用分析的方法测量青光眼患者视觉相关生活质量并初步分析其相关因素。方法收集北京同仁医院门诊确诊的青光眼患者，采用效用分析中的线性等级尺度(RS)法和时间交易(TTO)法进行问卷调查以获得反映青光眼患者疾病相关生活质量的效用值，比较RS法和TTO法所得效用值的差异和相关性，分析不同性别、年龄、受教育程度、工作状态、青光眼家族史、青光眼手术史、不同视功能损害程度以及不同青光眼类型对患者效用值的影响。结果研究共纳入青光眼患者86例，其中男62例，女24例;平均年龄44.67岁。RS法和TT0法测得青光眼患者的效用值分别为0.62±0.19和0.77±0.12，两种方法获得的效用值之间无显著相关关系( r=0.074，P=0.499)。RS法计算所得的效用值受日常生活视力、视野缺损程度以及青光眼手术史的影响，而TTO法测得的效用值主要与患者的年龄、工作状态以及受教育程度有关，与患者视力和视野损害的严重程度无相关性。校正了年龄、工作状态和受教育程度以后，较差眼视力≥0.3的青光眼患者其TTO效用值显著高于较差眼视力＜0.3者(P=0.029)。结论效用分析的方法简单、灵敏，可较好地被患者所接受。RS法所得效用值受日常生活视力、视野缺损程度以及青光眼手术史的影响，反映了患者对自身视觉状态的主观评价。TTO法测得的效用值主要与患者的年龄、工作状态以及受教育程度有关，反映了不同患病个体对自身视觉相关生活质量的主观评价。视功能的损害程度在青光眼患者的总体生活质量中不起决定性作用。揹景近年來關于青光眼對患者生活質量的影響日益受到臨床工作者的關註，但調查結果錶明各種視功能量錶均存在一定的不足，準確、全麵地評價影響青光眼患者生活質量的主觀和客觀因素值得深入研究。目的利用效用分析的方法測量青光眼患者視覺相關生活質量併初步分析其相關因素。方法收集北京同仁醫院門診確診的青光眼患者，採用效用分析中的線性等級呎度(RS)法和時間交易(TTO)法進行問捲調查以穫得反映青光眼患者疾病相關生活質量的效用值，比較RS法和TTO法所得效用值的差異和相關性，分析不同性彆、年齡、受教育程度、工作狀態、青光眼傢族史、青光眼手術史、不同視功能損害程度以及不同青光眼類型對患者效用值的影響。結果研究共納入青光眼患者86例，其中男62例，女24例;平均年齡44.67歲。RS法和TT0法測得青光眼患者的效用值分彆為0.62±0.19和0.77±0.12，兩種方法穫得的效用值之間無顯著相關關繫( r=0.074，P=0.499)。RS法計算所得的效用值受日常生活視力、視野缺損程度以及青光眼手術史的影響，而TTO法測得的效用值主要與患者的年齡、工作狀態以及受教育程度有關，與患者視力和視野損害的嚴重程度無相關性。校正瞭年齡、工作狀態和受教育程度以後，較差眼視力≥0.3的青光眼患者其TTO效用值顯著高于較差眼視力＜0.3者(P=0.029)。結論效用分析的方法簡單、靈敏，可較好地被患者所接受。RS法所得效用值受日常生活視力、視野缺損程度以及青光眼手術史的影響，反映瞭患者對自身視覺狀態的主觀評價。TTO法測得的效用值主要與患者的年齡、工作狀態以及受教育程度有關，反映瞭不同患病箇體對自身視覺相關生活質量的主觀評價。視功能的損害程度在青光眼患者的總體生活質量中不起決定性作用。
배경 근년래관우청광안대환자생활질량적영향일익수도림상공작자적관주，단조사결과표명각충시공능량표균존재일정적불족，준학、전면지평개영향청광안환자생활질량적주관화객관인소치득심입연구。 목적 이용효용분석적방법측량청광안환자시각상관생활질량병초보분석기상관인소。 방법수집북경동인의원문진학진적청광안환자，채용효용분석중적선성등급척도(RS)법화시간교역(TTO)법진행문권조사이획득반영청광안환자질병상관생활질량적효용치，비교RS법화TTO법소득효용치적차이화상관성，분석불동성별、년령、수교육정도、공작상태、청광안가족사、청광안수술사、불동시공능손해정도이급불동청광안류형대환자효용치적영향。 결과연구공납입청광안환자86례，기중남62례，녀24례;평균년령44.67세。RS법화TT0법측득청광안환자적효용치분별위0.62±0.19화0.77±0.12，량충방법획득적효용치지간무현저상관관계( r=0.074，P=0.499)。RS법계산소득적효용치수일상생활시력、시야결손정도이급청광안수술사적영향，이TTO법측득적효용치주요여환자적년령、공작상태이급수교육정도유관，여환자시력화시야손해적엄중정도무상관성。교정료년령、공작상태화수교육정도이후，교차안시력≥0.3적청광안환자기TTO효용치현저고우교차안시력＜0.3자(P=0.029)。 결론효용분석적방법간단、령민，가교호지피환자소접수。RS법소득효용치수일상생활시력、시야결손정도이급청광안수술사적영향，반영료환자대자신시각상태적주관평개。TTO법측득적효용치주요여환자적년령、공작상태이급수교육정도유관，반영료불동환병개체대자신시각상관생활질량적주관평개。시공능적손해정도재청광안환자적총체생활질량중불기결정성작용。
Background The influence of glaucoma on the quality of life in patients is of increasing concern for ophthalmologists in recent years. However,some studies demonstrated that different types of questionnaires about quality of life have various disadvantages. Therefore, to accurately and fully assess the influencing factors of quality of life in glaucoma patients is very important. Objective The present study was to survey the self-reported visionrelated quality of life(QOL) in glaucoma patients by means of utility analysis and to tentatively analyze its influencing factors. Methods Patients with glaucoma were recruited from a single tertiary ophthalmic department. Standard face-to-face interviews were conducted. Utility values of linear rating scale ( RS ) and time trade-off ( TTO ) were calculated to evaluate the self-reported vision-related QOL of the patients. The correlations of the utility values with the patients' general and ophthalmologic characteristics were also analyzed. This survey was approved by the Ethic Committee of Beijing Tongren Hospital. Oral informed consent was obtained from the subjects before the study.Results A cross-sectional study was designed. A total of 86 glaucoma patients were enrolled in this study with 62 male and 24 female, with a mean age of 44. 67 years old. The mean utility values measured by RS and TTO were 0. 62± 0. 19 and 0. 77 ± 0. 12, respectively, and no evidential correlation was found between these two values ( r =0. 074, P=0. 499 ). The RS value was associated with daily visual acuity,mean deviation(MD) of visual field and the history of trabeculectomy. Neither daily visual acuity nor MD showed a significant correlation with the TTO value. Age, work status and educational background contributed to higher utility value for the TTO method. After adjusting for age, work status and educational level,patients with visual acuity in the worse-seeing eye better than 0. 3 showed a higher TTO value than those with less than 0. 3. Conclusions Utility analysis possesses the advantages of convenience and sensitivity. RS utility value is easily affected by the Objective visual status and surgery history in glaucomatous patients,which reflects the subjective assessment of patients' visual quality. However, TTO value is primarily associated with age,work status and education level rather than visual function in glaucoma patients,which is therefore subjective assessment of the disease-related quality of life. These Results indicate that visual function impairment is not a determining factor for the QOL of glaucoma patients.