【摘要】目的采用欧洲五维度五水平健康量表(five-level EuroQol five-dimensional questionnaire, EQ-5D-5L)测量血液透析并发难治性继发甲状旁腺功能亢进症(secondary hyperparathyroidism，SHPT)患者的健康效用值，评价患者的生命质量及相关影响因素。方法采用EQ-5D-5L 量表调查北京中日友好医院150 例接受手术和拟钙剂西那卡塞药物治疗的SHPT 患者，从多个维度评价患者的生命质量，计算健康效用值，采用多元回归分析相关影响因素。结果共回收有效问卷144 份，年龄(48.17±10.95)岁，健康效用值0.89(0.78, 1.0)，视觉刻度尺(visual analogue scale，VAS)得分80(62.5，90.0)分。66.1%患者存在不同程度的疼痛或不舒服，自我照顾方面86.3%患者不存在任何困难。回归分析结果提示治疗方式、全段甲状旁腺激素(iPTH)水平和年龄对结果有影响，药物治疗组的健康效
用值较高(β 值分别为0.231、-0.176、-0.188，P 值分别为0.039、0.007、0.049)。结论接受治疗的难治性SHPT 患者总体生命质量较好，但疼痛和不舒服以及心理问题还是比较严重，应得到重视。换算的效用值可为疾病相关经济学研究提供数据支持。
【Abstract】Objective To use the Five- level EuroQol Five- dimensional Questionnaire (EQ- 5D- 5L) scale to measure the health utility value and to evaluate the quality of life and its related influencing factors in hemodialysis patients complicated with refractory secondary hyperparathyroidism (SHPT). Methods The ED-5Q-5L scale was used to evaluate the quality of life from multiple dimensions and to calculate the health utility values in a total of 150 hemodialysis patients with SHPT who received surgery and cinacalcet in China-Japan Friendship Hospital in Beijing. Multivariate regression analysis was used to analyze the related influencing factors. Results A total of 144 valid questionnaires were collected. The patients had an average age of 48.17± 10.95 years. The overall health utility value was 0.84±0.19, and the visual analogue scale (VAS) score was 80 (62.5, 90.0). Various degrees of pain or discomfort were present in 66.1% patients, and no difficulties in self-care were found in 86.3% patients. Regression analysis showed that treatment method, intact parathyroid hormone (iPTH) level and age impacted on the results. Patients in drug treatment group had higher health utility values (β=0.231, -0.176 and -0.188 respectively, P=0.039, 0.007 and 0.049 respectively). Conclusion The overall quality of life was improved in treated patients with refractory SHPT. However, pain, discomfort and psychological disorders are still problematic and should be taken into consideration. The data of converted utility value can be used to support the disease-related economic research.
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