| 郑亚明,杨娟,廖巧红.手足口病重症患者健康相关生存质量评估[J].中华流行病学杂志,2017,38(4):462-466 |
| 手足口病重症患者健康相关生存质量评估 |
| Health related quality of life on severe hand, foot and mouth disease patients |
| 收稿日期:2016-12-22 出版日期:2017-04-27 |
| DOI：10.3760/cma.j.issn.0254-6450.2017.04.010 |
| 中文关键词: 手足口病 重症 并发症 健康相关生存质量 |
| 英文关键词: Hand, foot and mouth disease Severe Complication Health related quality of life |
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| 中文摘要: |
| 目的 评估手足口病重症患者的健康相关生存质量。方法 以全国传染病监测信息报告管理系统2012年1月1日至2013年12月31日报告的实验室确诊的6月龄至5岁手足口病重症患者为研究对象，采用代理欧洲五维度健康量表，包括EQ-5D健康描述系统和视觉模拟标尺法（Visual Analogue Scale，EQ-VAS），通过电话调查方式获得患者在患病期间的健康相关生存质量。结果 对685名手足口病重症患者进行调查，男性456例（66.6%），519例（75.8%）研究对象为≤3岁儿童。337例（49.2%）和407例（59.4%）手足口病重症患者在行动能力和日常活动维度报告有问题，569例（83.1%）和616例（89.9%）患者在疼痛/不适和焦虑/抑郁维度报告有问题。重症患者的平均健康效用值为0.58±0.23，EQ-VAS评分为53.6±25.7，随病程延长评分降低。手足口病重症患者患病期间平均质量调整生命年损失为（15.45±13.75）年/1 000人，各并发症患者的质量调整生命年损失（年/1 000人）分别为呼吸道感染11.17 ±8.83；无菌性脑膜炎13.56±11.99；脑干脑炎/急性弛缓性麻痹（acute flaccid paralysis，AFP） 15.31±12.63；心肌炎17.28±18.16；肺出血/肺水肿17.34±14.98；心肺衰竭25.47±20.53。EV71相关患者的质量调整生命年损失为16.51±14.48，高于柯萨奇病毒A组16型（Cox A16）感染患者的13.02±11.45和其他肠道病毒感染患者的14.74±14.22（Z=11.83，P=0.003）。结论 手足口病重症患者的健康相关生存质量受影响较大，且随着并发症的加重和病程的延长而加重。 |
| 英文摘要: |
| Objective To evaluate the health related quality of life (HRQoL) for severe hand,foot and mouth disease (HFMD) patients with different complications. Methods A national telephone interview under the EQ-5D proxy2 questionnaire (EQ-SD and EQ-VAS), was conducted to obtain the HRQoL of lab-confirmed severe HFMD patients, aged between six months and five-year-olds from the national communicable disease surveillance system from January 1, 2012 to December 31, 2013. Results A total of 685 severe HFMD cases were included in the study. A total of 456 (66.6%) of them were males with 75.8% of them younger than three years old. A total of 337 (49.2%) and 407 (59.4%) of the participants reported that they had problems in mobility or daily activities. A total of 569 (83.1%) and 616 (89.9%) of the cases reported having problems in pain/discomfort or anxiety/depression. The average EQ-5D and EQ-VAS scores were 0.58±0.23 and 53.6±25.7, both were positively associated with the duration of illness. Mean quality adjusted life years loss during the HFMD episode for the severe patients was (15.45±13.75) years/1 000 persons. The QALY losses for severe patients with each of below complication were: respiratory diseases (11.17±8.83) years/1 000 persons, aseptic meningitis (13.56±11.99) years/1 000 persons, encephalitis/brainstem encephalitis/acute flaccid paralysis (AFP) (15.31±12.63) years/1 000 persons, Myocarditis (17.28±18.16) years/1 000 persons, pulmonary hemorrhage/pulmonary edema (17.34±14.98) years/1 000 persons, cardiopulmonary failure (25.47±20.53) years/1 000 persons. Among patients with lab confirmed Entero virus A71 (EV71) (16.51±14.48) years/1 000 persons, the QALY loss was seen higher than Coxsackie virus A16 (Cox A16) (13.02±11.45) years/1 000 persons and other Enter virus (14.74±14.22) years/1 000 persons (Z=11.83, P=0.003). Conclusion The HRQoL loss for severe HFMD patients substantially increased under complications exacerbation and related to the duration of illness. |
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