摘要
目的探讨住院骨质疏松症患者的健康相关生命质量状况及健康效用值,并分析其影响因素。方法以甘肃省人民医院住院骨质疏松症患者为调查对象,收集患者一般资料、检测骨代谢标志物,测量腰椎和髋部骨密度,评估患者跌倒风险、预测骨折、评估生命质量并计算健康效用值。采用Mann⁃Whitney检验及Kruskal⁃Wallis检验进行单因素分析,并用Tobit回归模型分析研究对象生命质量的影响因素。结果最终纳入241名住院骨质疏松症患者为研究对象,健康效用值为0.876(0.728~0.942)。单因素分析显示,年龄、文化程度、跌倒风险、居住地、吸烟、既往用抗骨松药物、低创骨折史、FRAX评分、左髋部T值、钙与骨质疏松患者健康效用值相关(P<0.05);Tobit回归模型结果显示,文化程度高(小学:β=0.119,P=0.043;初中:β=0.113,P=0.044;高中或中专或技校β=0.171,P=0.002)是生命质量的保护因素,跌倒风险高(中风险β=-0.138,P<0.001;高风险β=-0.316,P<0.001)、低创骨折史(β=-0.190,P<0.001)、FRAX评分为高危(β=-0.088,P=0.027)是生命质量的危险因素。结论与普通人群相比,住院骨质疏松症患者健康效用值下降,表明健康相关生命质量差。文化程度低、跌倒风险高、骨折以及FRAX评分高危的患者生命质量较差。为提高患者生命质量,应该加强对该类患者的健康宣教,预防跌倒并积极主动的进行干预,防止骨折及再骨折的发生。
Objective This study aimed to investigate the health⁃related quality of life and health utility value of hospitalized osteoporosis patients and to analyze the factors that influence them.Methods The study collected general data of osteoporosis patients hospitalized in Gansu Provincial Hospital,detected bone metabolism indexes,measured bone mineral density of the lumbar spine and hip,assessed fall risk,predicted fractures,evaluated quality of life,and calculated health utility values.The Mann⁃Whitney test and the Kluscal⁃Wallis test were used for univariate analysis.The Tobit regression model was used to analyze the factors affecting the quality of life of participants.Results A total of 241 hospitalized osteoporosis patients were enrolled as study subjects.Their health utility value was 0.876(0.728⁃0.942).Univariate analysis showed that age,education,risk of falls,place of residence,smoking,previous use of anti⁃osteoporosis drugs,low⁃invasive fracture history,FRAX score,left hip T⁃value,and calcium were associated with health utility values in patients with osteoporosis(P<0.05).The result of the Tobit regression model showed that a high literacy rate(primary school:β=0.119,P=0.043;junior high school:β=0.113,P=0.044;high school or college or technical schoolβ=0.171,P=0.002)was a protective factor for quality of life.High risk of fall(intermediate riskβ=-0.138,P<0.001;high⁃riskβ=-0.316,P<0.001),low⁃invasive fracture history(β=-0.190,P<0.001),and FRAX score of high risk(β=-0.088,P=0.027)were risk factors for quality of life.Conclusion The health utility value of hospitalized osteoporosis patients is lower than that of the general population,indicating poor health⁃related quality of life.Patients with low literacy rate,high risk of fall,fractures,and high risk of FRAX score have poorer quality of life.Improving the quality of life of patients,promoting health,preventing falls,and active intervening are necessary.
作者
杨帆
田利民
余静
张娜文
杨建宁
洪豆豆
温子英
杨瑞霞
张琦
YANG Fan;TIAN Limin;YU Jing;ZHANG Nawen;YANG Jianning;HONG Doudou;WEN Ziying;YANG Ruixia;ZHANG Qi(The First Clinical Medical College of Gansu University of Traditional Chinese Medicine(Gansu Provincial Hospital),Lanzhou 730000,China;Department of Geriatrics,Gansu Provincial Hospital,Lanzhou 730000,China)
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2024年第3期341-347,共7页
Chinese Journal of Osteoporosis
基金
建立中国骨质疏松性骨折注册登记网络平台(CORN)
全国协作网(2021YFC2501701)
国家自然科学基金(82160166,81960173)
甘肃省重点研发计划(22YF7FA096)
甘肃省人民医院院内科研基金(22GSSYA-1)
兰州市人才创新创业项目(2021-RC-136)
兰州市卫生健康科技发展项目(2021005)
甜蜜医生培育项目(2021SD01)
