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目的:评价成人特发性血小板减少性紫癜(ITP)对患者生活质量(QoL)的影响。方法:使用MedicalOutcome Study SF-36form(SF-36)中文版对中国医学科学院血液病医院236例成人ITP患者进行QoL调查。按照血小板计数,将患者分为3组[PLT<30×109/L;PLT(30~100)×109/L;PLT>100×109/L]。SF-36的8个维度作为测量结果:躯体健康(PF);社会功能(SF);躯体角色功能(RP);躯体疼痛(BP);心理健康(MH);情绪角色功能(RE);精力(VT);总体健康(GH)。结果:在8个维度ITP患者和正常人相比SF-36QoL均降低。在PF、RP、BP、GH、SF和RE等6个维度中QoL得分差异有统计学意义。急性ITP患者在GH、VT和RE3个维度与慢性患者相比QoL得分的差异有统计学意义。同时,在根据血小板计数分组的比较中,在PF、GH和SF3个维度显示了明显的差别。年龄是除了SF以外其他所有维度的负性预测因子。当前血小板计数是BP,SF和GH的负性预测因子。而且治疗费用也影响了QoL得分。对出血的恐惧作为主观指标对QoL有明显的负面影响。结论:成人ITP患者的QoL明显降低,年龄、血小板计数和出血的恐惧对QoL有明显的负面影响。本研究为ITP的临床研究提供了基于询证的证据。
Objective: To evaluate the effect of adult idiopathic thrombocytopenic purpura (ITP) on quality of life (QoL) in patients. Methods: A QoL survey of 236 adult ITP patients at the Hematology Hospital of Chinese Academy of Medical Sciences using the MedicalOutcome Study SF-36form (SF-36) Chinese version was conducted. Patients were divided into 3 groups according to platelet count [PLT <30 × 109 / L; PLT (30 ~ 100) × 109 / L; PLT> 100 × 109 / L]. The eight dimensions of SF-36 are the measurement results: physical health (PF); social function (SF); body function (RP); physical pain (BP); mental health (MH) (VT); overall health (GH). Results: SF-36QoL was lower in ITP patients and normal subjects in 8 dimensions. There were significant differences in QoL score among 6 dimensions of PF, RP, BP, GH, SF and RE. There was significant difference in QoL score between acute ITP patients and chronic patients in three dimensions of GH, VT and RE. At the same time, significant differences in PF, GH and SF3 dimensions were shown in the comparison based on platelet count. Age is a negative predictor of all dimensions except SF. Current platelet counts are negative predictors of BP, SF, and GH. And treatment costs also affect the QoL score. Fear of bleeding has a significant negative impact on QoL as a subjective indicator. CONCLUSIONS: QoL in adults with ITP was significantly lower and age, platelet count, and the fear of bleeding had a significant negative effect on QoL. This study provides evidence-based evidence for ITP clinical research.