中国哨点监测住院严重急性呼吸道感染病例生命质量分析

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摘要目的了解中国哨点监测住院严重急性呼吸道感染（severe acute respiratory infection, SARI）病例的健康相关生命质量（health-related quality of life, HRQoL）。方法 2013年12月-2014年1月,以2013年我国SARI监测系统报告的SARI病例为研究对象,采用EQ-5D量表通过电话调查的方式收集患者因SARI住院期间HRQoL。结果本研究成功调查122例SARI病例,年龄中位数为4岁（四分位数间距,interquartile range,IQR1-16岁）,病程中位数为11天（IQR 7-15天）。SARI住院病例主要在疼痛/不适（72.95%）和焦虑/沮丧（69.67%）两个维度报告有困难,EQ-5D VAS(visual analogue scale)均值为64.04分（标准差,standard deviation,SD19.48分）,健康效用值均值为0.68±0.24,平均损失的QALD为5.14±7.23天。多元线性回归分析显示,与5岁以下SARI病例相比,60岁以上SARI病例损失的QALD升高10.08天（95% confidence interval,95%CI 3.31-22.83天）。患有基础疾病者因SARI住院期间损失的QALD较未患基础疾病者升高3.70天（95%CI 2.00-6.23天）。结论本研究初步分析了中国哨点监测SARI病例的HRQoL,并首次使用中国人群特异性效用值换算表估计了SARI病例健康效用值和损失的QALD,发现60岁及以上年龄组和患有基础疾病的SARI病例HRQoL受影响较大。

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关键词 ：严重急性呼吸道感染, 住院病例, 健康相关生命质量

Abstract：Objective To estimate the health-related quality of life (HRQoL) of severe acute respiratory infection (SARI) inpatientsfrom sentinel hospitals in China. Methods A telephone survey using the EQ-5D instrument was conducted during December 2013-Januray 2014 to estimate the HRQoL of SARI hospitalization cases, who were registered in the National SARI Sentinel Surveillance Network in China in 2013. Results The study interviewed 122SARI inpatients. The median age of interviewed patients was 4 years old (interquartile range, IQR, 1-16), and the duration of the disease was 11 days (IQR 7-15). All five dimensions measured in the EQ-5D were affected, with pain/discomfort (72.95 %) and anxiety/depression 69.67 %) most affected. For SARI inpatients, the averageEQ-5D VAS(visual analogue scale) was 64.04(standard deviation,SD19.48), health utility was 0.68±0.24, and the quality adjusted life days (QALD) loss was 5.14±7.23 days. The multiplelinear regression analysis showed that the QALD loss of SARI inpatients aged 60 years and over increased 10.08 days (95 % confidenceinterval, 95 % CI3.31-22.83 days)compared to those aged under 5 years old (P<0.05). The presence of underlying illnesses was found toincrease the QALD loss by 3.70 days (95 % CI 2.00-6.23 days) (P<0.05). Conclusion This is the first study to analyze the HRQoLof SARI inpatients from sentinel hospitals in China,especially estimating the health utility and QALD loss using Chinese-specific value sets. It revealed that the HRQoL of SARI in patients aged 60 years and above and those with underlying medical conditions were much more affected.

基金资助:世界卫生组织流感项目（2010/94717-0）

通讯作者: 余宏杰,Email: yuhj@chinacdc.cn

引用本文:

杨娟郑亚明刘欣欣彭质斌冯录召余宏杰. 中国哨点监测住院严重急性呼吸道感染病例生命质量分析[J]. 实用预防医学, 2016, 23(5): 539-544. Yang Juan, Zheng Yaming, Liu Xinxin, Peng Zhibin, Feng Luzhao, Yu Hongjie.. Analysis on the health-related quality of life of severe acute respiratory infection inpatientsfrom sentinel hospitals in China. , 2016, 23(5): 539-544.

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