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目的分析重症肌无力(MG)患者的生活质量。方法纳入2013-03-2014-06在唐都医院神经内科就诊的MG患者188例,应用重症肌无力量化评分(QMGs)评估患者病情严重程度,采用36项简明健康状况调查表(SF-36)评估患者生活质量,采用汉密尔顿抑郁量表(HDRS)和汉密尔顿焦虑量表(HARS)评估抑郁和焦虑症状。比较不同教育水平、职业、眼肌型重症肌无力(ocular MG,OMG)症状、胸腺情况等患者间SF-36评分的差异,并对QMG评分、年龄、HARS和HDRS得分与SF-36两项复合得分进行多元线性回归分析。结果高级教育组在躯体疼痛项得分高于初级教育组(P<0.05),学生组在生理机能项(P<0.05)和生理角色功能项(P<0.05)得分均高于脑力劳动组,学生组在生理角色功能项得分亦高于体力劳动组(P<0.05);学生组在生理复合得分(PCS)项得分高于按照职业分组的其他3组(均P<0.05);OMG组在精神复合得分(MCS)项得分高于全身型重症肌无力(generalized MG,GMG)组(P<0.05)。较高的QMGs、HARS得分和高龄可以预测较低的PCS得分,较高的QMGs和HARS得分可预测较低的MCS得分。结论影响MG患者生活质量的因素包括年龄、教育水平、职业、胸腺情况、MG的类型和GMG的类型、疾病的严重程度和心理障碍。较高的QMGs和HARS得分可以预测较低的PCS和MCS得分,年龄大可预测较低的PCS得分。
Objective To analyze the quality of life in patients with myasthenia gravis (MG). Methods A total of 188 patients with MG were enrolled in the Department of Neurology of Tangdu Hospital from March 2013 to June 2014. The severity of illness was assessed by QMGs. Thirty-six short form health status questionnaires (SF-36) Patients were assessed for quality of life and depressive and anxiety symptoms were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Scale (HARS). The differences of SF-36 scores among different education levels, occupations, symptoms of ocular MG (OMG) and thymus were compared. The QMG score, age, HARS and HDRS scores were compared with those of SF-36 Multiple scores for multiple linear regression analysis. Results The score of somatic pain in higher education group was higher than that of primary education group (P <0.05). The score of physiological function (P <0.05) and physiological role function (P <0.05) (P <0.05). Students in the Physical Component Score (PCS) score were higher than those in the other 3 groups (P <0.05). OMG group in the spirit Compound score (MCS) score was higher than that of generalized MG (GMG) group (P <0.05). Higher QMGs, HARS scores, and advanced age predicted lower PCS scores, while higher QMGs and HARS scores predicted lower MCS scores. Conclusions The factors influencing the quality of life of patients with MG include age, level of education, occupation, thymus, type of MG and type of GMG, severity of illness and psychological disorder. Higher QMGs and HARS scores predict lower PCS and MCS scores and older age predicts lower PCS scores.