中华行为医学与脑科学杂志
中華行為醫學與腦科學雜誌
중화행위의학여뇌과학잡지
CHINESE JOURNAL OF BEHAVIORAL MEDICINE AND BRAIN SCIENCE
2014年
10期
904-908
,共5页
Graves病%131-碘%心理健康%生活质量
Graves病%131-碘%心理健康%生活質量
Graves병%131-전%심리건강%생활질량
Grave's disease%131I%Mental health%Quality of life
目的 探讨Graves病(GD)患者在接受131I治疗一年后疾病影响程度及生活质量状况.方法 纳入GD患者376例.患者自愿接受131I治疗,建立随访档案,分别在接受131I治疗前、治疗后第6月、12月采用疾病影响程度量表(SIP)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会功能缺陷筛查量表(SDSS)及生活质量问卷(QLS)进行评估.结果 失访57例,319例完成随访.131I治疗前、治疗后6月及12月各量表总分及因子分均数差异存在统计学意义,治疗后SAS、SDS、SDSS、SIP总分及各因子分评分降低(F=8.561 ～ 1080.317,P＜0.001),SF-36量表总分与各因子分均较治疗前有所升高(P＜0.05).治疗后12月与6月相比,SAS、SDS、SDSS、SIP总分、SIP因子分SD-Ⅱ、SR、W与SF-36因子分RP、BP、VT、SF差异无统计学意义(P＞0.05);SIP因子分SD-Ⅰ、HM、RP与SF-36总分及因子分PF、GH、RE、MH差异有统计学意义(P＜0.05),SIP因子分SD-Ⅰ、HM、RP较6月时高(P＜0.05),而SF-36总分及因子分PF、GH、RE、MH较6月时低 (P＜0.05);治疗后6月、12月时不同临床结局组各量表总分及SIP因子分SD-Ⅰ、SD-Ⅱ、SR、W、RP与SF-36因子分PF、RP、BP、GH、VT、SF、RE、MH差异均有统计学意义(F6=6.870～143.79,F12=13.956～837.184,P＜0.001),SIP量表HM因子分在6月与12月时均差异无统计学意义(F6=1.733,P6=0.142;F12=2.015,P12=0.092).治疗后6月与12月时甲状腺功能正常组与健康对照组相比,SF-36总分及因子分PF、RP、VT、SF、RE、MH仍差异有统计学意义(F=8.320～ 82.791,P≤0.001);因子分BP、GH比较差异无统计学意义(F=2.990、2.652,P=0.051、0.072).结论 GD患者生活质量严重下降,131I治疗可以改善患者总体生活质量,但社会心理状况改善并不理想,关注GD患者生活质量,提供有效的心理干预是提高GD患者愈后的重要措施.
目的 探討Graves病(GD)患者在接受131I治療一年後疾病影響程度及生活質量狀況.方法 納入GD患者376例.患者自願接受131I治療,建立隨訪檔案,分彆在接受131I治療前、治療後第6月、12月採用疾病影響程度量錶(SIP)、焦慮自評量錶(SAS)、抑鬱自評量錶(SDS)、社會功能缺陷篩查量錶(SDSS)及生活質量問捲(QLS)進行評估.結果 失訪57例,319例完成隨訪.131I治療前、治療後6月及12月各量錶總分及因子分均數差異存在統計學意義,治療後SAS、SDS、SDSS、SIP總分及各因子分評分降低(F=8.561 ～ 1080.317,P＜0.001),SF-36量錶總分與各因子分均較治療前有所升高(P＜0.05).治療後12月與6月相比,SAS、SDS、SDSS、SIP總分、SIP因子分SD-Ⅱ、SR、W與SF-36因子分RP、BP、VT、SF差異無統計學意義(P＞0.05);SIP因子分SD-Ⅰ、HM、RP與SF-36總分及因子分PF、GH、RE、MH差異有統計學意義(P＜0.05),SIP因子分SD-Ⅰ、HM、RP較6月時高(P＜0.05),而SF-36總分及因子分PF、GH、RE、MH較6月時低 (P＜0.05);治療後6月、12月時不同臨床結跼組各量錶總分及SIP因子分SD-Ⅰ、SD-Ⅱ、SR、W、RP與SF-36因子分PF、RP、BP、GH、VT、SF、RE、MH差異均有統計學意義(F6=6.870～143.79,F12=13.956～837.184,P＜0.001),SIP量錶HM因子分在6月與12月時均差異無統計學意義(F6=1.733,P6=0.142;F12=2.015,P12=0.092).治療後6月與12月時甲狀腺功能正常組與健康對照組相比,SF-36總分及因子分PF、RP、VT、SF、RE、MH仍差異有統計學意義(F=8.320～ 82.791,P≤0.001);因子分BP、GH比較差異無統計學意義(F=2.990、2.652,P=0.051、0.072).結論 GD患者生活質量嚴重下降,131I治療可以改善患者總體生活質量,但社會心理狀況改善併不理想,關註GD患者生活質量,提供有效的心理榦預是提高GD患者愈後的重要措施.
목적 탐토Graves병(GD)환자재접수131I치료일년후질병영향정도급생활질량상황.방법 납입GD환자376례.환자자원접수131I치료,건립수방당안,분별재접수131I치료전、치료후제6월、12월채용질병영향정도량표(SIP)、초필자평량표(SAS)、억욱자평량표(SDS)、사회공능결함사사량표(SDSS)급생활질량문권(QLS)진행평고.결과 실방57례,319례완성수방.131I치료전、치료후6월급12월각량표총분급인자분균수차이존재통계학의의,치료후SAS、SDS、SDSS、SIP총분급각인자분평분강저(F=8.561 ～ 1080.317,P＜0.001),SF-36량표총분여각인자분균교치료전유소승고(P＜0.05).치료후12월여6월상비,SAS、SDS、SDSS、SIP총분、SIP인자분SD-Ⅱ、SR、W여SF-36인자분RP、BP、VT、SF차이무통계학의의(P＞0.05);SIP인자분SD-Ⅰ、HM、RP여SF-36총분급인자분PF、GH、RE、MH차이유통계학의의(P＜0.05),SIP인자분SD-Ⅰ、HM、RP교6월시고(P＜0.05),이SF-36총분급인자분PF、GH、RE、MH교6월시저 (P＜0.05);치료후6월、12월시불동림상결국조각량표총분급SIP인자분SD-Ⅰ、SD-Ⅱ、SR、W、RP여SF-36인자분PF、RP、BP、GH、VT、SF、RE、MH차이균유통계학의의(F6=6.870～143.79,F12=13.956～837.184,P＜0.001),SIP량표HM인자분재6월여12월시균차이무통계학의의(F6=1.733,P6=0.142;F12=2.015,P12=0.092).치료후6월여12월시갑상선공능정상조여건강대조조상비,SF-36총분급인자분PF、RP、VT、SF、RE、MH잉차이유통계학의의(F=8.320～ 82.791,P≤0.001);인자분BP、GH비교차이무통계학의의(F=2.990、2.652,P=0.051、0.072).결론 GD환자생활질량엄중하강,131I치료가이개선환자총체생활질량,단사회심리상황개선병불이상,관주GD환자생활질량,제공유효적심리간예시제고GD환자유후적중요조시.
Objective To evaluate the sickness impact and the quality of life in patients who received 131 I treatment for Grave's disease with one year of follow-up.Methods 376 patients with Grave's disease(GD) who voluntarily received 131I treatment were recruited.The follow-up archives were established.The Sickness Impact and the Quality of life in patient' s with GD were measured using the Sickness Impact Profile (SIP),Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale(SAS) and Social Disability Screening Schedule (SDSS) and Quality of life scale(QLS,SF-36) before and after treatment with 131I for 6 months and 12 months.Results 57 out of 376 cases were lost.319 cases finished follow-up studies.There was significant difference of SAS,SDS,SDSS,SIP and SF-36 and their agent score among three groups:before and 6months and 12months after 131I treatment in the 319 patients(F=8.561-1080.317,P＜0.001).After treatment with 131I,SAS,SDS,SDSS and SIP score were lower(P＜0.05),SF-36 total and agent score were higher(P＜0.05).There was no significant difference between the score of SAS,SDS,SDSS,SIP total score and it' s agent score of SD-Ⅱ,SR,W,SF-36 agent score of RP,BP,VT,SF at the end of 12 months compared to the score at the end of 6 months(P＞0.05).But there was significant difference between the score of SIP agent score of SD-Ⅰ,HM,RP,SF-36 total score and it' s agent score of PF,GH,RE,M H at the end of 12 months compared to the score at the end of 6 months (P＜0.05).At the end of 6 months and 12 months after treatment the subjects were divided five groups according to different clinical outcome.Not only at the end of 6 months,but also at the end of 12 months,there was significant difference of SAS,SDS,SDSS,SIP total score,and it' s agent score of SD-Ⅰ,SD-Ⅱ,SR,W,RP,SF-36 total score,and it's agent score PF,RP,BP,GH,VT,SF,RE,MH among the five groups(F6 =6.870-143.790,F12 =13.956-837.184,P＜0.001).There was no significant difference of HM among five groups (F6 =1.733,P6 =0.142; F12 =2.015,P12 =0.092).The score of SF-36 and its agent score PF,RP,VT,SF,RE,MH in three subgroup (healthy control,the patient group at end of 6 months and 12 months with normal thyroid function) was significant different,respectively(F=8.320-82.791,P＜0.001).There was no significant different for agent score of BP and GH(F=2.990,2.652,P=0.051,0.072).Conclusion Quality of life of patients with GD is decrease.131I treatment can improve it,but socialpsycho function can not be improved satisfactorily.It is necessary for GD patients to pay attention to the quality of life and provide effective mental intervention to improve the recovery completely.
