成年女性癫■患者生活质量的影响因素分析
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摘要
目的研究成年女性癫■患者的生活质量损害特点及影响因素,为提高成年女性癫■患者生活质量提供临床依据。方法收集2013至2018年就诊于上海交通大学医学院附属新华医院神经内科门诊及住院的107例女性癫■患者,依据年龄分为3组:18～27岁组、28～37岁组和38～49岁组。所有患者完成一般情况调查表和癫■患者生活质量调查表-31 (QOLIE-31)评分,采用单因素及多因素分析各影响因素与生活质量的关系。结果 107例患者中,①生活质量各项条目:除"认知功能"与"社会功能"评分分数较高,其余各项条目分数均偏低,以"综合生活质量"分数最低。②3组患者生活质量各项条目的评分:"药物影响"及"综合生活质量"项差异有统计学意义,其余各项评分差异无统计学意义。③单因素相关分析:年龄、婚姻、就业情况、药物数量和发作频率等为患者生活质量的影响因素;多元逐步回归分析:发作频率、就业情况为主要影响因素。结论女性癫■患者的癫■发作频率和就业情况为其生活质量的主要影响因素,备孕期女性患者对抗癫■药物对胎儿的影响更为担心。
Aim To determine the characteristics and influencing factors of quality of life in adult female epilepsy patients. Methods 107 women with epilepsy were collected from the outpatient and inpatient department of neurology,Xinhua Hospital from 2013 to 2018. According to the age,they were divided into three groups( a 18-27 years old group,a 28-37 years old group and a 38-49 years old group).All of them completed the general condition questionnaire and the Quality of Life Inventory in Epilepsy-31( QOLIE-31). Single factor and multivariate analysis were used to compare the relationship between the influencing factors and the quality of life. Results In these patients,among all the sub-items of quality of life,the scores of "cognitive"and "social function"were higher,but the scores of other sub-items were lower,and the score of "overall quality of life"was the lowest. Among the scores of each sub-item of quality of life in three groups,there were no significant difference except for "medication effects"and"overall quality of life". Univariate correlation analysis found that age,marriage,employment,numbers of antiepileptic drugs and frequency of seizures were the factors affecting the quality of life of women with epilepsy. Multiple stepwise regression analysis showed that frequency of seizures and employment were the main influencing factors. Conclusion Seizure frequency and employment significantly influence the quality of life of women with epilepsy. Women with epilepsy who may become pregnant are more worried about the impact of antiepileptic drugs.
Aim To determine the characteristics and influencing factors of quality of life in adult female epilepsy patients. Methods 107 women with epilepsy were collected from the outpatient and inpatient department of neurology,Xinhua Hospital from 2013 to 2018. According to the age,they were divided into three groups( a 18-27 years old group,a 28-37 years old group and a 38-49 years old group).All of them completed the general condition questionnaire and the Quality of Life Inventory in Epilepsy-31( QOLIE-31). Single factor and multivariate analysis were used to compare the relationship between the influencing factors and the quality of life. Results In these patients,among all the sub-items of quality of life,the scores of "cognitive"and "social function"were higher,but the scores of other sub-items were lower,and the score of "overall quality of life"was the lowest. Among the scores of each sub-item of quality of life in three groups,there were no significant difference except for "medication effects"and"overall quality of life". Univariate correlation analysis found that age,marriage,employment,numbers of antiepileptic drugs and frequency of seizures were the factors affecting the quality of life of women with epilepsy. Multiple stepwise regression analysis showed that frequency of seizures and employment were the main influencing factors. Conclusion Seizure frequency and employment significantly influence the quality of life of women with epilepsy. Women with epilepsy who may become pregnant are more worried about the impact of antiepileptic drugs.
引文
[1]Grant AC,Prus N,Nakhutina L.Factors affecting quality of life in epilepsy in a multi-ethnic urban population[J].Epilepsy Behav,2013,27:283-285
[2]Santos AMC,Castro-Lima H,Matos MAA,et al.Quality of life among women with epilepsy during their reproductive years[J].Epilepsy Behav,2018,85:10-13
[3]Benavente-Aguilar I,Morales-Blnquez C,Rubio EA,et al.Quality of life of adolescents suffering from epilepsy living in the community[J].J Paediatr Child Health,2004,40:110-113
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[6]Djibuti M,Shakarishvili R.Influence of clinical,demographic,and socioeconomic variables on quality of life in patients with epilepsy:findings from Georgian study[J].J Neurolo Neurosurg Psychiatry,2003,74:570-573
[7]Beghi E,Roncolato M,Vison1 G.Depression andaltered quality of life in women with epilepsy of childbearing age[J].Epilepsia,2004,45:64-70
[8]王秀锋,陈晏,李蕾,等.中国北方成人癫患者生活质量的影响因素及性别差异[J].中华神经科杂志,2017,50:34-39
[9]潘英,翟云霞,黄淡銮.癫患者生活质量影响因素分析[J].中华神经医学杂志,2010,09:1147-1149
[10]Chen HF,Tsai YF,Hsi MS,et al.Factors affecting quality of life in adults with epilepsy in Taiwan:A cross-sectional,correlational study[J].Epilepsy Behav,2016,58:26-32
[11]Cramer JA,Perrine K,Devinsky O,et al.Development and cross-cultural translations of a 31-item quality of life in epilepsy inventory[J].Epilepsia,1998,39:81-88
[12]刘雪琴,任晓琳,周谷兰,等.成年癫患者生活质量-31量表的信度和效度[J].中华神经医学杂志,2003,2:106-109
[13]任晓琳,梁平,刘雪琴.癫患者生活质量量表-31(中文版)的翻译及修订[J].解放军护理杂志,2003,20:99-101
[14]Baker GA,Smith DF,Dewey M,et al.The initial development of a health-related quality of life model as an outcome measure in epilepsy[J].Epilepsy Res,1993,16:65-81
[15]邵勇,丁玎,虞培敏,等.育龄期女性癫患者社会心理及生活质量的研究[J].中国临床神经科学,2010,18:46-53
[16]Kubota H,Awaya Y.Assessment of health-related quality of life and influencing factors using QOLIE-31 in Japanese patients with epilepsy[J].Epilepsy Behav,2010,18:381-387
[17]Espinosa Jovel CA,Ramírez SS,Rincón RC,et al.Factors associated with quality of life in a low-income population with epilepsy[J].Epilepsy Research,2016,127:168-174
[18]Ridsdale L,Wojewodka G,Robinson E,et al.Characteristics associated with quality of life among people with drug-resistant epilepsy[J].J Neurol,2017,264:1174-1184
[19]Robson C,Myers L,Pretorius C,et al.Health related quality of life of people with non-epileptic seizures:The role of sociodemographic characteristics and stigma[J].Seizure,2018,55:93-99
[20]Taylor RS,Sander JW,Taylor RJ,et al.Predictors of healthrelated quality of life and costs in adults with epilepsy:a systematic review[J].Epilepsia,2011,52:2168-2180
[21]Melikyan E,Guekht A,Milchakova L,et al.Health-related quality of life in Russian adults with epilepsy:the effect of sociodemographic and clinical factors[J].Epilepsy Behav,2012,25:670-675
[22]Mohamed S,Gill JS,Tan CT.Quality of life of patients with epilepsy in Malaysia[J].Asia Pac Psychiatry,2014,6:105-109
[23]Kinyanjui DW,Kathuku DM,Mburu JM.Quality of life among patients living with epilepsy attending the neurology clinic at Kenyatta National Hospital,Nairobi,Kenya:a comparative study[J].Health Qual Life Outcomes,2013,11:98
[24]岳丽,虞培敏,赵德豪,等.癫患者生活质量的影响因素及其年龄性别差异[J].中华医学杂志,2010,90:1597-1601
[25]Viale L,Allotey J,Cheong-See F,et al.Epilepsy in pregnancy and reproductive outcomes:a systematic review and metaanalysis[J].Lancet,2015,386:1845-1852
[26]Wen X,Meador KJ,Hartzema A.Antiepileptic drug use by pregnant women enrolled in Florida Medicaid[J].Neurology,2015,84:944-950
[27]Tricco AC,Cogo E,Angeliki VA,et al.Comparative safety of anti-epileptic drugs among infants and children exposed in utero or during breastfeeding:protocol for a systematic review andnetwork meta-analysis[J].Syst Rev,2014,3:68
[28]Baker GA,Bromley RL,Briggs M,et al.IQ at 6 years after inutero exposure to antiepileptic drugs:a controlled cohortstudy[J].Neurology,2015,84:382-390
[29]Emes RD,Clifford H,Haworth KE,et al.Antiepileptic drugs and the fetal epigenome[J].Epilepsia,2013,54:e16-e19
[30]Kilic D,Pedersen H,Kjaersgaard MI,et al.Birth outcomes after prenatal exposure to antiepileptic drugs-a population-based study[J].Epilepsia,2014,55:1714-1721
[2]Santos AMC,Castro-Lima H,Matos MAA,et al.Quality of life among women with epilepsy during their reproductive years[J].Epilepsy Behav,2018,85:10-13
[3]Benavente-Aguilar I,Morales-Blnquez C,Rubio EA,et al.Quality of life of adolescents suffering from epilepsy living in the community[J].J Paediatr Child Health,2004,40:110-113
[4]Shetty PH,Naik RK,Saroja A,et al.Quality of life in patients with epilepsy in India[J].J Neurosci Rural Pract,2011,2:33-38
[5]Alanis-Guevara I,Pe1a E,Corona T,et al.Sleep disturbances,socioeconomic status,and seizure control as main predictors of quality of life in epilepsy[J].Epilepsy Behav,2005,7:481-485
[6]Djibuti M,Shakarishvili R.Influence of clinical,demographic,and socioeconomic variables on quality of life in patients with epilepsy:findings from Georgian study[J].J Neurolo Neurosurg Psychiatry,2003,74:570-573
[7]Beghi E,Roncolato M,Vison1 G.Depression andaltered quality of life in women with epilepsy of childbearing age[J].Epilepsia,2004,45:64-70
[8]王秀锋,陈晏,李蕾,等.中国北方成人癫患者生活质量的影响因素及性别差异[J].中华神经科杂志,2017,50:34-39
[9]潘英,翟云霞,黄淡銮.癫患者生活质量影响因素分析[J].中华神经医学杂志,2010,09:1147-1149
[10]Chen HF,Tsai YF,Hsi MS,et al.Factors affecting quality of life in adults with epilepsy in Taiwan:A cross-sectional,correlational study[J].Epilepsy Behav,2016,58:26-32
[11]Cramer JA,Perrine K,Devinsky O,et al.Development and cross-cultural translations of a 31-item quality of life in epilepsy inventory[J].Epilepsia,1998,39:81-88
[12]刘雪琴,任晓琳,周谷兰,等.成年癫患者生活质量-31量表的信度和效度[J].中华神经医学杂志,2003,2:106-109
[13]任晓琳,梁平,刘雪琴.癫患者生活质量量表-31(中文版)的翻译及修订[J].解放军护理杂志,2003,20:99-101
[14]Baker GA,Smith DF,Dewey M,et al.The initial development of a health-related quality of life model as an outcome measure in epilepsy[J].Epilepsy Res,1993,16:65-81
[15]邵勇,丁玎,虞培敏,等.育龄期女性癫患者社会心理及生活质量的研究[J].中国临床神经科学,2010,18:46-53
[16]Kubota H,Awaya Y.Assessment of health-related quality of life and influencing factors using QOLIE-31 in Japanese patients with epilepsy[J].Epilepsy Behav,2010,18:381-387
[17]Espinosa Jovel CA,Ramírez SS,Rincón RC,et al.Factors associated with quality of life in a low-income population with epilepsy[J].Epilepsy Research,2016,127:168-174
[18]Ridsdale L,Wojewodka G,Robinson E,et al.Characteristics associated with quality of life among people with drug-resistant epilepsy[J].J Neurol,2017,264:1174-1184
[19]Robson C,Myers L,Pretorius C,et al.Health related quality of life of people with non-epileptic seizures:The role of sociodemographic characteristics and stigma[J].Seizure,2018,55:93-99
[20]Taylor RS,Sander JW,Taylor RJ,et al.Predictors of healthrelated quality of life and costs in adults with epilepsy:a systematic review[J].Epilepsia,2011,52:2168-2180
[21]Melikyan E,Guekht A,Milchakova L,et al.Health-related quality of life in Russian adults with epilepsy:the effect of sociodemographic and clinical factors[J].Epilepsy Behav,2012,25:670-675
[22]Mohamed S,Gill JS,Tan CT.Quality of life of patients with epilepsy in Malaysia[J].Asia Pac Psychiatry,2014,6:105-109
[23]Kinyanjui DW,Kathuku DM,Mburu JM.Quality of life among patients living with epilepsy attending the neurology clinic at Kenyatta National Hospital,Nairobi,Kenya:a comparative study[J].Health Qual Life Outcomes,2013,11:98
[24]岳丽,虞培敏,赵德豪,等.癫患者生活质量的影响因素及其年龄性别差异[J].中华医学杂志,2010,90:1597-1601
[25]Viale L,Allotey J,Cheong-See F,et al.Epilepsy in pregnancy and reproductive outcomes:a systematic review and metaanalysis[J].Lancet,2015,386:1845-1852
[26]Wen X,Meador KJ,Hartzema A.Antiepileptic drug use by pregnant women enrolled in Florida Medicaid[J].Neurology,2015,84:944-950
[27]Tricco AC,Cogo E,Angeliki VA,et al.Comparative safety of anti-epileptic drugs among infants and children exposed in utero or during breastfeeding:protocol for a systematic review andnetwork meta-analysis[J].Syst Rev,2014,3:68
[28]Baker GA,Bromley RL,Briggs M,et al.IQ at 6 years after inutero exposure to antiepileptic drugs:a controlled cohortstudy[J].Neurology,2015,84:382-390
[29]Emes RD,Clifford H,Haworth KE,et al.Antiepileptic drugs and the fetal epigenome[J].Epilepsia,2013,54:e16-e19
[30]Kilic D,Pedersen H,Kjaersgaard MI,et al.Birth outcomes after prenatal exposure to antiepileptic drugs-a population-based study[J].Epilepsia,2014,55:1714-1721
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