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林 琳,朱燕波.高血压患者体质量指数与生存质量的关联性[J].中国康复医学杂志,2015,(7):672~678
高血压患者体质量指数与生存质量的关联性    点此下载全文
林 琳  朱燕波
北京师范大学社会发展与公共政策学院,北京,100875
基金项目:国家重点基础研究发展计划(973计划)资助(2011CB505403)
DOI:
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摘要:
      摘要 目的:探讨高血压患者体质量指数(BMI)与生存质量(HRQOL)的关联性。 方法:1463例高血压患者源于中国9省市(江苏、安徽、甘肃、青海、福建、北京、吉林、江西、河南)横断面健康状况调查数据库。生存质量使用中文版简明健康调查量表进行调查,血压由经过统一培训的医生现场测量。应用非参数秩和检验比较不同BMI分类的高血压患者生存质量的差异;应用Logistic回归模型,排除性别、年龄、婚姻状况、文化程度、运动习惯、血压水平、合并疾病因素影响后,分析不同体质量指数对生存质量的独立影响。 结果:不同体质量指数的高血压患者,在生存质量的生理领域(PCS)、心理领域(MCS)以及PF、RP、GH、VT、SF、RE、MH 7个维度的得分差异具有显著性意义。无论在PCS领域还是MCS领域,均是超重组得分最高(PCS=72.56±19.34,MCS=75.78±18.75),体质量过低组得分最低(PCS=56.56±22.47,MCS=61.13±21.81)。不同性别、年龄、婚姻状况、文化程度、运动习惯、血压水平及有无合并疾病情况下,不同BMI分类的高血压患者生存质量不同。排除混杂因素影响后的Logistic回归结果显示,体质量过低的高血压患者在PCS领域(OR=3.08,95%CI:1.21—7.82)、MCS领域(OR=2.19,95%CI:1.04—4.61)以及PF、RP、VT、SF、RE维度生存质量受损的危险度是体质量正常组的2.14—3.44倍;肥胖的高血压患者在PF维度(OR=1.48,95%CI:1.06—2.06)生存质量受损的危险度是体质量正常组的1.48倍;而超重的高血压患者在GH维度(OR=0.75,95%CI:0.58—0.96)生存质量受损的危险度是体质量正常组的0.75倍。 结论:体质量过低减损高血压患者生理、心理领域及多个维度的生存质量,肥胖减损高血压患者生理机能维度的生存质量,超重对高血压患者一般健康状况维度的生存质量有保护作用。
关键词:高血压  体质量指数  生存质量  简明健康调查问卷SF-36
The association between body mass index and health-related quality of life in hypertension patients    Download Fulltext
China Japan Friendship Hospital, Beijing, 100029
Fund Project:
Abstract:
      Abstract Objective: To investigate the association between body mass index (BMI) and health-related quality of life (HRQOL) in hypertension patients, based on a cross-sectional survey conducted in Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi and Henan provinces and city of China. Method: Data of 1463 hypentension patients were collected from the cross-sectional survey database in 9 provinces and city of China. HRQOL was surveyed through medical outcomes study(MOS) items of short form health survey (SF-36). Blood pressure was measured in situ by doctor. Rank sum test was used to compare HRQOL with different BMI category. Logistic regression analysis was used to assess the impact of different BMI category on HRQOL after adjust for sex, age, marital, education, physical activity status, blood pressure and complications. Result: The hypertension patients with different BMI classification had significantly different HRQOL scores in physical component summary(PCS), mental component summary(MCS) and 7 dimensions of physical functioning(PF), role-physical(RP), general health(GH), vitality(VT), social functioning(SF), role-emotional(RE) and mental health(MH). The overweight BMI group had the highest HRQOL score in PCS (72.56±19.34) and MCS (75.78±18.75), while the underweight group had the worst HRQOL (PCS=56.56±22.47, MCS=61.13±21.81). Hypertension patients in different gender, age, marital status, educational level, exercise habits, blood pressure and complications had different QOL scores between different BMI classifications. Compared with normal weight patients, data on odds ratio (OR) of impaired HRQOL in PCS (OR=3.08, 95%CI: 1.21—7.82), MCS (OR=2.19, 95%CI: 1.04—4.61) and PF, RP, VT, SF, RE dimensions increased 2.14—3.44 times among underweight patients. ORs of impaired HRQOL in PF dimension (OR=1.48, 95%CI: 1.06—2.06) increased 1.48 times among obese patients. ORs of impaired HRQOL in GH dimension (OR=0.75, 95%CI: 0.58—0.96) decreased among overweight patients. Conclusion: Underweight was associated with HRQOL impairment in most dimensions, obese was associated with HRQOL impairment in physical functioning(PF), while overweight was associated with HRQOL protection in general health(GH).
Keywords:hypertension  body mass index  health-related quality of life  the medical outcomes study 36-item short form health survey
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