摘要
目的探究膝骨关节炎患者健康相关生活质量(HRQoL)的影响因素,并分析膝骨关节炎的非手术治疗方式。方法收集2017年12月至2018年11月在北京市五家医院骨科门诊就诊的膝骨关节炎患者的人口统计学变量、治疗方式、影像学资料以及12条目简短生命质量量表(SF-12)评分,分析HRQoL的影响因素及非手术治疗方式。结果共纳入2034例患者,男530例(26.1%),女1504例(73.9%),年龄(59.17±10.22)岁。在躯体生活质量方面,与男性相比,女性膝骨关节炎患者的生理总评分较低(β=-0.521,P=0.036);与年龄<55岁者相比,年龄≥64岁者生理总评分较低(β=-0.636,P=0.026);与受教育年限≤9年的人群相比,受教育年限≥13年的人群生理总评分较高(β=1.063,P<0.001);与轻度临床症状者相比,中度临床症状者生理总评分较低(β=-0.860,P=0.002),而重度临床症状者则更低(β=-1.126,P<0.001)。与未经治疗者相比,采用多种方式联合治疗者生理总评分较高(β=0.731,P=0.005)。在心理生活质量方面,与久坐工作人群相比,轻度体力工作人群的心理总评分较低(β=-0.712,P=0.015);与Charson合并症指数为0的人群相比,Charson合并症指数≥2的人群心理总评分较低(β=-1.183,P=0.007)。在过去的12个月中,使用过非甾体类抗炎药、对乙酰氨基酚、氨基葡萄糖/软骨素制剂、物理治疗、关节腔穿刺注射药物、中医治疗以及运动治疗的患者分别为648例(31.9%)、143例(7.0%)、406例(20.0%)、680例(33.4%)、343例(16.9%)、681例(33.5%)、170例(8.4%)。使用单一治疗和联合治疗的患者分别为451例(22.2%)、889例(43.7%)。结论北京市膝骨关节炎患者的非手术治疗方式以非甾体抗炎药、理疗和中医治疗为主,联合治疗的使用比例高于单一治疗。躯体生活质量与性别、年龄、受教育程度、症状严重程度及治疗方式相关,而心理生活质量与职业劳动性质和合并症相关。
Objective To explore the influencing factors of health-related quality of life(HRQoL)in patients with knee osteoarthritis,and to analyze the non-surgical treatment of knee osteoarthritis.Methods Demographic variables,treatment modalities,imaging data,and 12-item short form health survey(SF-12)scores of patients with knee osteoarthritis in orthopedic outpatient departments of five hospitals in Beijing from December 2017 to November 2018 were collected to analyze influencing factors of HRQoL and non-surgical treatment.Results A total of 2034 patients were included.There were 530 males(26.1%)and 1504 females(73.9%),with a mean age of(59.17±10.22)years.In terms of physical quality of life,female patients with knee osteoarthritis had lower physical components summary(PCS)compared with male patients(β=-0.521,P=0.036);patients aged≥64 years had lower PCS than those aged<55 years(β=-0.636,P=0.026).Patients with an education of more than 12 years had higher PCS than those with less than 10 years(β=1.063,P<0.001).Compared to patients with mild clinical symptoms,the PCS of patients with moderate clinical symptoms was lower(β=-0.860,P=0.002),while the PCS of those with severe clinical symptoms was much lower(β=-1.126,P<0.001).Patients treated with combination therapy had higher PCS than untreated patients(β=0.731,P=0.005).In terms of mental quality of life,compared to patients engaged in sedentary work,the mental components summary(MCS)of patients engaged in mild manual labor jobs was lower(β=-0.712,P=0.015);Compared to patients with a Charson comorbidity index of 0,patients with a Charlson comorbidity index≥2 had lower MCS(β=-1.183,P=0.007).In the past 12 months,648(31.9%),143(7.0%),406(20.0%),680(33.4%),343(16.9%),681(33.5%),170(8.4%)patients had used non-steroid anti-inflammatory drugs(NSAIDs),acetaminophen,glucosamine/chondroitin formulations,physical therapy,articular cavity puncture injection,traditional Chinese medicine treatment and exercise therapy,respectively.Total of 451 patients(22.2%)received monotherapy and 889 patients(43.7%)received combination therapy.Conclusions The major non-surgical treatment methods for patients with knee osteoarthritis in Beijing are NSAIDs,physiotherapy and traditional Chinese medicine.Combination therapy is used more frequently than monotherapy.Physical quality of life is related to gender,age,education,severity of symptoms and treatment,while mental quality of life is related to occupational labor and comorbidities.
作者
周歌
赵旻暐
曹永平
林剑浩
王卫国
郭艾
田华
Ge Zhou;Minwei Zhao;Yongping Cao;Jianhao Lin;Weiguo Wang;Ai Guo;hua Tian(Department of orthopedics,Peking University Third Hospital,Engineering Research Center of Bone and Joint Precision Medicine,Ministry of Education,Beijing 100191,China;Department of Orthopedics,Peking University First Hospital,Beijing 100034,China;Department of Orthopedics,Peking University People′s Hospital,Beijing 100044,China;Department of Orthopedics,China-Japan Friendship Hospital,Beijing 100029,China;Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2022年第35期2799-2805,共7页
National Medical Journal of China
基金
北京市科委计划项目(D171100003217001)
北大医学青年科技创新培育基金(BMU2021PYB034)。
关键词
骨关节炎
膝
生活质量
非手术治疗
多中心横断面研究
Osteoarthritis,knee
Quality of life
Non-surgical treatment
Multicenter cross-sectional study
