膝骨关节炎合并骨质疏松症患者生存质量及相关因素分析

发布时间：2018-04-17 11:08

本文选题：膝骨关节炎 + 骨质疏松症　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:调查膝骨关节炎合并骨质疏松症患者生存质量状况,分析影响患者生存质量的相关因素,以期提高整个膝骨关节炎合并骨质疏松症患者的生存质量;指导治疗方案,为社区医疗提供更多可靠的方案;为临床工作提供理论基础,填补地方流行病学数据库。方法:采用SF-36量表结合生活习惯、医疗等信息的调查表,对广西中医药大学第一附属医院门诊或住院就诊已经确诊为膝骨关节炎合并骨质疏松症患者,展开发病后的生存质量的问卷调查,收集相关资料并录入数据库,采用方差分析、t检验、多元回归逐步分析等统计学方法对患者生存质量状况可能相关因素进行分析。结果:本研究调查的KOA合并OP病人生存质量总分均值与标准差为60.04±11.022。其中各维度的评分情况分别为:一般健康状态(GH)得分为54.77±8.213;生理机能状态(PF)得分为61.61±13.902;生理职能状态(RP)得分为57.08±11.542;情感职能状态(RE)得分为72.64±19.180;社会功能状态(SF)得分为64.92±18.965;躯体疼痛状态(BP)得分为72.05±12.648;活力状态(VT)得分为54.20±17.854;精神健康状态(RP)得分为64.64±14.631。本次调查发现,年龄与一般健康、生理机能、生理职能、社会功能、精神健康、量表总分维度呈负向相关;性别与生理机能、生理职能、活力状态、量表总分维度呈负向相关,与社会功能维度呈正向相关;体重指数与生理功能维度呈负相关,在其它维度差异不明显,无统计学意义;体育锻炼与生理职能维度呈正相关,在其它维度无统计学意义;职业与生理职能维度呈负相关,在其它维度无统计学意义;文化教育程度、日照与八个维度及量表总分均无统计学意义;KOA累及单侧还是双侧与一般健康、生理职能、精神健康维度呈负相关;既往疾病与社会功能维度呈负相关;吃水果蔬菜与一般健康、生理职能、情感职能、活力状态、精神健康、量表总分呈正相关;吃海产品与活力状态成正比,在其它维度无统计学意义;吃豆制品与生理情感职能、精神状况、社会功能维度呈负相关;喝牛奶与一般健康维度呈正相关,与生理职能、躯体疼痛、量表总分呈负相关,在其它维度差异不显著,无统计学意义;喝咖啡与生理职能、量表总分维度呈正相关,在其它维度无统计学意义;吸烟与生理机能、生理职能、情感职能、社会功能维度呈负面影响;饮酒与生理职能维度呈正相关,与社会功能维度呈负相关。结论:膝骨关节炎合并骨质疏松症病人的生存质量尚处于较低水平,对生存质量的影响也是生理、心理、社会等多层面的,各维度受影响的大小依次为情感职能躯体疼痛社会功能精神健康生理机能生理职能一般健康活力状态。患者生活质量总分以及各维度影响较大的因素是骨密度(腰椎)、年龄、性别、蔬菜水果摄入、吸烟、单双膝发病(OA累及单侧或双侧膝关节)、牛奶的摄入、豆制品摄入、饮酒、喝咖啡等。其中保护因素为腰椎骨密度、吃蔬菜水果、体育锻炼、摄入适量海产品,有利于病人生存质量的改善;危险因素为年龄、性别、吸烟、体重指数、体力相关职业、摄入过量咖啡和酒精、既往病史,可降低KOA合并OP患者的生存质量;不确定因素为牛奶的摄入、豆制品、单双膝发病、民族、文化程度、日照,尚需要进一步大样本的研究证实。
[Abstract]:Objective: To investigate the knee osteoarthritis patients with osteoporosis in the quality of life, to analyze the factors affecting the quality of life of the patients, in order to improve the quality of life of patients with knee osteoarthritis and osteoporosis; therapy for community health, provide more reliable solution; provide theoretical basis for clinical work, fill the local epidemiological database. Methods: the combination of SF-36 scale and living habits, medical information on outpatient questionnaire, the First Affiliated Hospital of Guangxi TCM university or hospital treatment has been diagnosed with knee osteoarthritis and osteoporosis, investigation of quality of life after the onset of the related data were collected and entered into the database, using variance analysis, t test and multiple stepwise regression analysis on quality of life in patients with possible related factors analysis and other statistical methods. Results: the research Check the KOA and OP patients quality of life score and the standard deviation is 60.04 + 11.022. the score of each dimension are: general state of Health (GH) score was 54.77 + 8.213; physiological function status (PF) score was 61.61 + 13.902; physiological function status (RP) score was 57.08 + 11.542; emotional function status (RE) score was 72.64 + 19.180; social function (SF) score was 64.92 + 18.965; state body pain (BP) score was 72.05 + 12.648; activity status (VT) score was 54.20 + 17.854; mental health status (RP) score was 64.64 + 14.631. found in the survey, age and general health, physiological function, physiological function, social function, mental health, the total scores of dimensions are negatively correlated; gender and physiological function, physiological function, vitality, the total scores of dimensions are negatively correlated, showed a positive correlation with social function dimension; body mass index and physiological function dimension Negative correlation, in other dimensions have no significant difference, no statistical significance; the dimension of sports exercise and physiological function were positively correlated, but no significant difference was found in other dimensions; negative correlation dimension of occupation and physiological function, no significant differences in other dimensions; cultural education, sunshine and eight dimensions and the total scores were not statistically meaning; KOA involved unilateral or bilateral and general health, physiological function, mental health dimensions were negatively correlated; negatively related to medical and social function dimensions; eat fruits and vegetables and general health, physical function, emotional function, mental health, vitality, scores were positively correlated; eat seafood and energy is proportional to the state, no statistical significance in other dimensions; eat soy products and physiological and emotional function, mental health, social function dimension was negatively correlated; drink milk showed positive correlation with the general health and physiological functions of the body dimensions. The pain scores were negatively correlated, no significant differences in other dimensions, no statistical significance; coffee and physiological functions, scores were positively correlated, with no difference in other dimensions; smoking and physiological function, physiological function, emotional function, social function dimension has negative influence; alcohol consumption was positively correlated with the physiology the function dimension was negatively correlated with the social function dimension. Conclusion: the quality of life of patients with knee osteoarthritis and osteoporosis is still at a relatively low level, influence the quality of life of psychological and physical, social, and other aspects of the various dimensions of the affected order of emotional function mental health social function of physiological body pain the physiology function of general health vitality. The quality of life of patients with total scores and each dimension of the influence factors on bone mineral density (lumbar), age, gender, smoking, intake of vegetables, fruit, single and double knee disease (OA with unilateral or bilateral knee joint), milk intake, intake of bean products, alcohol, coffee and so on. The protective factors for bone mineral density, eating fruits and vegetables, physical exercise, adequate intake of seafood, is conducive to improve the quality of life of patients; risk factors as age, gender, smoking, body mass index, physical the related occupation, excessive intake of coffee and alcohol, past medical history, can reduce the quality of life of patients with KOA OP; uncertain factors for milk intake, bean products, single and double knee disease, nationality, culture degree, sunshine, still needs further study with large sample confirmed.

【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R580;R684.3

【参考文献】