癫痫患者生活质量的影响因素及其年龄性别差异

摘要

Objective To determine factors associated with quality of life(QOL)in epileptics and the variations between men and women,younger and older people.Methods A total of 204 patients(160 younger,49 older;125 men,79 women)were interviewed by the quality of life in epilepsy-31(QOLIE-31),side effect profile(SEP),self-rating anxiety scale(SAS)and Hamilton depression scale(HAMD).Medical and socio-demographic data were acquired from patient records.Multivariate linear regressive analyses were used to determine the set of best predictors of composite QOLIE-31 score.Results No statistical difference was revealed in QOLIE-3l overall score either between younger and older patients or between men and women.Among all patients,regressive analyses revealed that SEP(β=-0.395,P=0.000)and SAS(β=-0.152,P=0.016)were two strong predictors of QOLIE-31 overall score.Grouped by gender,among men,epilepsy duration(β:-0.165,P=0.028)and seizure frequency(β=-0.284,P=0.001) respectively associated with QOLIE-31 overall score and"social function"score while the number of AEDs(antiepileptic drugs)substantially correlated with QOLIE-31 overall score among women (β=-0.238,P=0.006).Grouped by ages,seizure frequency(β=-0.284,P=0.000) and education level(β=0.203,P=0.005)predicted QOLIE-31"social function"score only among younger patients;among older patients,a significant association were found between the number of AEDs and QOLIE-31 overall score(β=-0.363,P=0.004).Conclusion Side effects of AEDs and number of AEDs exert greater effect on QOL in women and older patients.And such seizure-related vailables as epileptic duration and seizure frequency influence QOL only among men and younger patients.%目的 研究癫痫患者生活质量的影响因素并比较男性和女性、青年和中老年癫痫患者生活质量影响因素的差异.方法 收集自2004年10月至2008年11月就诊于华山医院神经内科门诊的癫痫患者,并完成癫痫患者生活质量量表(QOLIE-31)、抗癫痫药物不良反应量表(SEP)、焦虑自评量表(SAS)和汉密尔顿抑郁量表(HAMD)的评定.应用多元逐步回归分析各影响因素与生活质量的关系及其组间差异.结果 共完成204例癫痫患者,其中青年患者160例,中老年患者44例,女性79例,男性125例.女性与男性患者、中老年与青年患者的QOLIE-31总分差异无统计学意义.SEP 评分(β=-0.395,P=0.000)和SAS评分(β=-0.152,P=0.016)是癫痫患者QOLIE-31总分的重要预测因素.性别比较,病程(β=-0.165,P=0.028)和发作频率(β=-0.284,P=O.001)分别与男性患者QOLIE-31总分和"社会活动"得分相关,用药数量与女性患者QOLIE-31总分(β=-0.238,P=0.006)和多个分项分相关.年龄比较,发作频率(β=-0.284,P=0.000)和学历(β=0.203,P=0.005)与青年患者QOLIE-31"社会活动"得分相关,用药数量(β=-0.363,P=0.004)与中老年患者QOLIE-31总分相关.结论 药物不良反应和用药数量对女性和中老年患者的生活质量影响更为显著;发作频率等疾病本身因素对男性和青年癫痫患者的生活质量影响更大.