葡萄膜炎患者视觉相关生活质量及心理状态调查

发布时间：2018-09-17 19:22

【摘要】：目的:1.调查葡萄膜炎患者治疗后的视觉相关生活质量(VRQoL),分析其与视功能之间的关系及其影响因素。2.比较不同葡萄膜炎患者治疗后的视觉相关生活质量有无差异。3.调查葡萄膜炎患者的心理健康状况,并分析葡萄膜炎患者的心理状况与视觉相关生活质量的相互关系。4.分析视觉相关生活质量在眼科疾病应用中的意义。方法:1.自2015年12月至2017年2月间,收集就诊于天津市眼科医院的葡萄膜炎患者104例。将所有患者分两组,第一组进行视觉相关生活质量问卷调查;第二组患者进行视觉相关生活质量与心理状态的问卷调查研究。2.第一组葡萄膜炎患者50例。所有患者均进行眼科检查,明确诊断,且患者符合入选标准及排除标准。所有入选者均被征得知情同意后,采用视觉相关生活质量量表(NEI-VFQ-25)中文版进行问卷调查。3.第二组葡萄膜炎患者54例,同样接受眼科相关检查,符合纳入标准后,进行问卷填写调查。4.问卷调查:对患者的一般资料及相关病情进行记录,告知患者问卷的目的,所有患者在同一医师的监督下完视觉成两个量表的填写。5.应用SPSS 18.0统计软件对葡萄膜炎患者的VRQoL评分进行统计分析,对量表中总分及各亚项得分用均数±标准差(_x±s)描述其平均水平和离散程度。所有患者的一般情况进行分组,采用独立样本t检验进行比较,应用Pearson相关分析法分析VRQoL评分与不同类型炎症和视力损害程度之间的关系,应用相关分析法分析视觉相关生活质量与心理状况的关系。以p≤0.05作为差异有统计学意义的界限。结果:(一)葡萄膜炎患者生活质量比较1.不同疾病特征生活质量比较:对患者一般资料分组进行分析,合并全身疾病的患者的整体健康(21.6±14.0/47.3±23.9)有统计学意义(p=0.000),45岁及以上患者在总体视力、近距离活动、远距离活动、社会活动、精神健康、依赖性和色觉亚项以及总分差异均有统计学意义(p0.05)。2.不同疾病类型患者生活质量比较:单眼受累和双眼受累组在总体视力、近距离活动、远距离活动、社会活动、驾驶车辆、色觉、周边视力以及总均分差异有统计学意义(t=2.51~3.68,p0.05)。有无眼部并发症患者除外总体健康、总体视力及社会活动差异无统计学意义外(t=0.67~1.92,p0.05),其余亚项差异均有统计学意义(t=2.850~3.163,p0.05)。任一眼视力低于0.3的患者组与双眼视力优于0.3者除整体健康及眼痛项无统计学意义外(t=0.67~1.64,p0.05),其余各亚项差异均有统计学意义(t=2.50~4.72,p0.05)。3.相关分析比较:对患者视力损害与VRQoL得分进行相关分析,显示除整体健康和眼痛无相关外(p0.05),其余多项与眼部视力损害呈负相关(r=-0.45~-0.54,p0.05)。有眼部并发症的患者除整体健康、眼痛、社会活动和周边视力无相关外(p0.05),其余各项均与VRQoL得分呈负相关(r=-0.29~0.40,p0.05)。年龄与各亚项进行相关分析,除整体健康无相关外(p0.05),其余各项均与年龄呈负相关(r=-0.29~-0.49,p0.05)。(二)葡萄膜炎患者焦虑和抑郁比较1.焦虑抑郁得分:所有患者焦虑平均得分为4.63±3.73,抑郁平均得分为3.73±3.53。焦虑及抑郁患者各为9例,阳性率为17.6%。2.将葡萄膜炎患者的焦虑、抑郁得分与VRQoL总均分分别进行相关分析,发现焦虑得分与总均分呈负相关关系,r值为-0.587,p0.01。抑郁得分与总均分呈负相关关系,r值为-0.617,p0.01。结论:1.葡萄膜炎患者的视觉相关生活质量普遍较低,葡萄膜炎对患者的生活质量产生了较严重的影响。2.葡萄膜炎患者的视力损害越严重,其视觉相关生活质量得分越低。说明葡萄膜炎患者的视力损害严重影响了患者的日常生活质量。3.葡萄膜炎视力损害、眼部并发症、年龄与患者的视觉相关生活质量都有一定的相关关系。患者年龄越大,VRQoL得分越低。无眼部并发症患者得分较高。4.葡萄膜炎患者有一定程度的焦虑和抑郁改变,并且与视觉相关生活质量呈负相关,说明焦虑和抑郁是影响葡萄膜炎患者生活质量的因素。5.NEI-VFQ-25问卷能敏感地反映和评价葡萄膜炎患者的VRQoL及其相关因素。6.根据葡萄膜炎患者视觉相关生活质量以及心理状态的改变,提示我们在治疗葡萄膜炎疾病的同时应关注葡萄膜炎患者的生活质量和心理状态。
[Abstract]:Objective: 1. To investigate the visual-related quality of life (VRQoL) in patients with uveitis after treatment, and to analyze the relationship between VRQoL and visual function and its influencing factors. 2. To compare the differences of visual-related quality of life among different uveitis patients after treatment. 3. To investigate the mental health status of patients with uveitis and analyze the psychological status of patients with uveitis. Methods: 1. From December 2015 to February 2017, 104 patients with uveitis were collected from Tianjin Ophthalmological Hospital. All patients were divided into two groups. The first group was given a questionnaire survey on the quality of life related to vision. Patients in the second group were investigated with visual-related quality of life and psychological status questionnaire. 2. 50 patients with uveitis in the first group. All patients underwent ophthalmic examinations to confirm the diagnosis, and the patients met the inclusion criteria and exclusion criteria. Chinese version of the questionnaire survey. 3. The second group of 54 patients with uveitis, the same ophthalmic examination, in line with the inclusion criteria, to fill in the questionnaire survey. 4. Questionnaire survey: the general information of patients and related conditions were recorded to inform patients of the purpose of the questionnaire, all patients under the supervision of the same physician completed two scales. The VRQoL scores of patients with uveitis were analyzed by SPSS 18.0 statistical software. The total scores and the sub-items of the scale were described by mean (x s) standard deviation (x s). The general conditions of all patients were grouped and compared by independent sample t test and Pearson correlation analysis. The relationship between VRQoL score and different types of inflammation and visual impairment was analyzed, and the relationship between visual-related quality of life and mental status was analyzed by correlation analysis. The general data were grouped and analyzed. The overall health of the patients with systemic diseases was statistically significant (p = 0.000). There were significant differences in the overall visual acuity, brachytherapy, teleactivity, social activity, mental health, dependence, color perception sub-items and total scores between the patients aged 45 and over (p 0.05). Quality of life of patients with different types of diseases: there were significant differences in overall visual acuity, short-distance activity, long-distance activity, social activity, driving vehicles, color vision, peripheral visual acuity and total mean score between unilateral and binocular involvement groups (t = 2.51-3.68, p0.05). No significant difference was found in the other sub-items (t = 2.850-3.163, p0.05). No significant difference was found between the patients with visual acuity less than 0.3 and those with binocular visual acuity better than 0.3 (t = 0.67-1.64, p0.05), except for overall health and eye pain (t = 2.50-4.72, p0.05). Correlation analysis and comparison: The correlation analysis between visual impairment and VRQoL score showed that there was no correlation between overall health and eye pain (p0.05), and many other visual impairments were negatively correlated (r = - 0.45 ~ - 0.54, p0.05). Patients with eye complications had no correlation except overall health, eye pain, social activities and peripheral vision (p0.05). Age was negatively correlated with VRQoL score (r=-0.29-0.40, p0.05). Age was negatively correlated with age (r=-0.29-0.49, p0.05) except for overall health (p0.05). The other items were negatively correlated with age (r=-0.29-0.49, p0.05). (2) Comparison of anxiety and depression in patients with uveitis 1. Anxiety and depression score: the average anxiety score of all patients was 4.63 + 3.73, and depression was flat. The average score of anxiety and depression was 3.73 (+3.53). The positive rate of anxiety and depression was 17.6%. 2. Correlation analysis between anxiety and depression scores and the total average score of VRQoL showed that anxiety score was negatively correlated with the total average score, r value was - 0.587, P 0.01. Depression score was negatively correlated with the total average score, R value was - 0.617, P 0.01.Conclusion: 1. The visual-related quality of life of uveitis patients is generally low, uveitis has a more serious impact on the quality of life of patients. 2. The more serious the visual impairment of uveitis patients, the lower the score of visual-related quality of life. The older the patient is, the lower the VRQoL score is. The higher the score is in patients without eye complications. 4. The patients with uveitis have a certain degree of anxiety and depression changes, and have a negative correlation with the quality of vision-related life, indicating anxiety. The NEI-VFQ-25 questionnaire can sensitively reflect and evaluate VRQoL and its related factors in patients with uveitis. 6. According to the changes of visual-related quality of life and psychological status in patients with uveitis, we should pay attention to uveitis while treating uveitis. People's quality of life and mental state.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R773.9

【参考文献】