文章摘要
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
投稿时间:2016-12-22  
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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作者单位E-mail
郑亚明 102206 北京, 中国疾病预防控制中心传染病预防控制处 传染病监测预警国家重点实验室  
杨娟 102206 北京, 中国疾病预防控制中心传染病预防控制处 传染病监测预警国家重点实验室  
廖巧红 102206 北京, 中国疾病预防控制中心传染病预防控制处 传染病监测预警国家重点实验室 liaoqh@chinacdc.cn 
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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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