哮喘联盟

   摘要
   目的:探究哮喘合并症对患者健康相关生活质量 (HRQoL) 的影响以及合并症与哮喘控制的相互关系。
   方法:一个成年哮喘人群作为随机样本,我们采用通用的(EQ5D) 和疾病特异性 (AQ5D)量表进行评分。根据2014GINA指南评估哮喘症状控制情况。使用经过验证的调查问卷对合并症进行计分。我们使用两部分的回归模型以确定调整过的症状控制水平和合并症评分的差异，并了解在HRQoL变化时，症状控制和合并症的相互影响情况。
   结果:共计460例成人患者的2,299 项观察结果 (平均年龄52岁, 67%为女性) 被包括在内。与已控制的哮喘相比, 控制不佳的哮喘与EQ5D减少-0.018相关 (95% CI -0.028, -0.009)，与 AQ5D减少 -0.076 相关(95% CI -0.115, -0.052) 。 合并症评分相对于平均值增加1个标准差会改变EQ5D值为-0.029 (95% CI -0.043, -0.016)，AQLQ为-0.010 (95% CI -0.020, -0.004)。在解释EQ5D的变异时(12 vs. 1%)，合并症的影响大于哮喘症状控制，但解释 AQ5D 的变异时，前者影响较小。 (3 vs. 12%).
   结论:通用的和特定疾病的HRQoL在捕获哮喘控制症状和合并症的影响方面存在差异。哮喘研究中对HRQoL的选择应当依据目标人群中合并症的患病率情况，和对于哮喘控制和合并症干预控制情况而定。


 

（苏欣 审校）
Qual Life Res. 2015 Jun 3. [Epub ahead of print]

 

The added effect of comorbidity on health-related quality of life in patients withasthma.
 

Chen W1, Lynd LD, FitzGerald JM, Marra CA, Rousseau R, Sadatsafavi M.
 

Abstract
PURPOSE:To examine the effect of comorbidities on health-related quality of life (HRQoL) and their interaction with asthma control.
METHODS:In a random sample of adults with asthma, we measured generic (EQ5D) and disease-specific (AQ5D) utility scores. Asthma symptom control was determined using the 2014 Global Initiative for AsthmaManagement Strategy. Comorbidity scores were calculated using a validated questionnaire. We used two-part regression models to measure the adjusted difference in utility across levels of symptom control and comorbidity scores and to examine the relative role of symptom control and comorbidity in explaining the variation in HRQoL.
RESULTS:A total of 2,299 observations from 460 adult patients (mean age 52 years, 67 % women) were included. Compared to controlled asthma, uncontrolled asthma was associated with -0.018 reduction (95 % CI -0.028, -0.009) in EQ5D and -0.076 reduction (95 % CI -0.115, -0.052) in AQ5D utilities. An increase by one standard deviation in comorbidity score relative to the mean was associated with a change of -0.029 (95 % CI -0.043, -0.016) in EQ5D and -0.010 (95 % CI -0.020, -0.004) in AQLQ utilities. The impact of comorbidity was greater than asthma symptom control in explaining EQ5D variance (12 vs. 1 %) but smaller in explaining AQ5D variance (3 vs. 12 %).
CONCLUSIONS:Generic and disease-specific HRQoL instruments differentially capture the impact of symptom control and comorbidity in asthma. The selection of HRQoL instruments for asthma studies should depend on the prevalence of comorbidity in the target population and the impact of interventions on asthmacontrol and comorbidity.
 

Qual Life Res. 2015 Jun 3. [Epub ahead of print]