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山东大学学报 (医学版) ›› 2020, Vol. 1 ›› Issue (7): 115-121.doi: 10.6040/j.issn.1671-7554.0.2020.0080

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心血管疾病患者健康相关生命质量及其影响因素的多水平模型分析

邓清文,刘文彬   

  1. 福建医科大学公共卫生学院卫生管理学系, 福建 福州 350122
  • 出版日期:2020-07-20 发布日期:2020-07-10
  • 通讯作者: 刘文彬. E-mail:wenbinliu126@126.com
  • 基金资助:
    福建省高校杰出青年科研人才培育计划(2018B030)

Multilevel analysis of health related quality of life of patients with cardiovascular disease and its determinants

DENG Qingwen, LIU Wenbin   

  1. Department of Health Management, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian, China
  • Online:2020-07-20 Published:2020-07-10

摘要: 目的 探讨心血管疾病患者的健康相关生命质量及其影响因素,为改善患者生命质量提供参考。 方法 选取2015年中国健康与养老追踪调查(CHARLS)中符合要求的心血管疾病患者1 201例,收集患者及地区信息,基于欧洲五维健康量表(EQ-5D-3L)测量健康效用值反映其健康相关生命质量。采用K-W检验对患者和地区因素进行单因素分析。以患者水平为水平1,地区水平为水平2,建立两水平回归模型,分析患者和地区因素对心血管疾病患者健康相关生命质量的影响。 结果 健康效用值平均值为0.749±0.166。单因素分析结果显示,心血管疾病患者健康相关生命质量的影响因素包括性别、受教育水平、婚姻状况、是否患有高血压、是否患有心脏病、是否患有中风、睡眠时长、吸烟状况、饮酒状况、每周中等强度体力活动时间、社交活动频率、体质量指数(BMI)、所在地区(P<0.05)。多水平模型结果显示,对心血管疾病患者健康相关生命质量有显著影响的因素有性别、受教育水平、婚姻状况、是否患有高血压病、是否患有血脂异常、是否患有心脏病、是否患有中风、吸烟状况、每周中等强度体力活动时间、社交活动频率、BMI以及地区水平的地区因素(P<0.05)。 结论 提高心血管疾病患者的健康相关生命质量既要考虑受教育水平、吸烟状况、BMI等个体因素,还应考虑不同地区患者的异质性,从而制定不同地区的针对性策略。

关键词: 心血管疾病, 健康相关生命质量, 健康效用值, 多水平回归模型, 欧洲五维健康量表

Abstract: Objective To explore health related quality of life(HRQoL)of patients with cardiovascular disease(CVD)and identify the influencing factors. Methods A total of 1 201 CVD patients eligible for the research requirements were selected from CHARLS investigation. Patients information and regions were collected. HRQoL was measured using EQ-5D-3L scale. Patients information and regions were analyzed with K-W test. With patient as level 1 and region as level 2, a two-level regression model was set up to identify the influencing factors. Results The mean health utility value was 0.749±0.166. Univariate analysis showed that determinants of HRQoL of CVD patients included gender, educational level, marital status, hypertension, heart disease, stroke, sleep duration, smoking status, drinking status, minutes of moderate-intensity physical activity per week, frequency of social activity, body mass index(BMI)and region(P<0.05). Multilevel model results indicated that determinants of HRQoL of CVD patients were gender, education level, marital status, hypertension, dyslipidemia, heart disease, stroke, smoking status, minutes of moderate-intensity physical activity per week, frequency of social activity, BMI and region(P<0.05). Conclusion To improve quality of life of CVD patients, education level, smoking status, BMI and heterogeneity of different regions should be considered so as to develop targeted strategies.

Key words: Cardiovascular disease, Health related quality of life, Health utility value, Multilevel model, EQ-5D-3L scale

中图分类号: 

  • R181.3
[1] 马丽媛, 吴亚哲, 陈伟伟. 《中国心血管病报告2018》要点介绍[J]. 中华高血压杂志, 2019, 27(8): 712-716.
[2] 徐琼琼, 郭晓雷, 楚洁, 等. 山东省2型糖尿病患者健康相关生命质量及其影响因素[J]. 山东大学学报(医学版), 2019, 57(3): 96-103. XU Qiongqiong, GUO Xiaolei, CHU Jie, et al. Health-related quality of life and its influencing factors in type 2 diabetes patients in Shandong Province[J] Journal of Shandong University(Health Sciences), 2019, 57(3): 96-103.
[3] 黄海涌, 汤少梁, 刘军军. 基于欧洲五维健康量表的浙川冀甘4省慢性病患者的健康相关生命质量现状及影响因素研究[J]. 中国慢性病预防与控制, 2019, 27(8): 575-579. HUANG Haiyong, TANG Shaoliang, LIU Junjun. The life quality related to health and influencing factors of chronic disease patients in Zhejiang,Sichuan,Hebei and Gansu Provinces based on EQ-5D-5L scale[J]. Chinese Journal of Prevention and Control of Chronic Diseases, 2019, 27(8): 575-579.
[4] Mok A, Khaw KT, Luben R, et al. Physical activity trajectories and mortality: population based cohort study[J]. BMJ, 2019, 365: l2323. doi:10.1136/bmj.l2323.
[5] Lear SA, Hu W, Rangarajan S, et al. The effect of physical activity on mortality and cardiovascular disease in 130000 people from 17 high-income, middle-income, and low-income countries: the PURE study[J]. Lancet, 2017, 390(10113): 2643-2654.
[6] Mora S, Cook N, Buring JE, et al. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms[J]. Circulation, 2007, 116(19): 2110-2118.
[7] Domínguez F, Fuster V, Fernández-Alvira JM, et al. Association of sleep duration and quality with subclinical atherosclerosis[J]. J Am Coll Cardiol, 2019, 73(2): 134-144.
[8] 国际生命科学学会中国办事处中国肥胖问题工作组联合数据汇总分析协作组. 中国成人体质指数分类的推荐意见简介[J]. 中华预防医学杂志, 2001, 35(5): 349-350.
[9] Zhou BF, Cooperative Meta-analysis Group of the Working Group on Obesity in China. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut-off points of body mass index and waist circumference in Chinese adults[J]. Biomed Environ Sci, 2002, 15(1): 83-96.
[10] EuroQol Research Foundation. EQ-5D-3L/About[EB/OL].[2020-01-11]. https://euroqol.org/eq-5d-instruments/eq-5d-3l-about/, 2018.
[11] 刘文燕. 老年人生命质量评价及影响因素研究——基于CHARLS2012浙江和甘肃两省调查数据[D]. 南昌: 华东交通大学, 2015.
[12] Zhuo L, Xu L, Ye J, et al. Time trade-off value set for EQ-5D-3L based on a nationally representative Chinese population survey[J]. Value Health, 2018, 21(11): 1330-1337.
[13] 杨珉, 李晓松. 医学和公共卫生研究常用多水平统计模型[M]. 北京: 北京大学医学出版社, 2007.
[14] 石磊. 多水平模型及其在经济领域中的应用[M]. 北京: 科学出版社, 2013.
[15] Kularatna S, Byrnes J, Chan YK, et al. Comparison of the EQ-5D-3L and the SF-6D(SF-12)contemporaneous utility scores in patients with cardiovascular disease[J]. Qual Life Res, 2017, 26(2): 1-10.
[16] Heiskanen J, Tolppanen AM, Roine RP, et al. Comparison of EQ-5D and 15D instruments for assessing the health-related quality of life in cardiac surgery patients[J]. Eur Heart J Qual Care Clin Outcomes, 2016: 193-200. doi: 10.1093/ehjqcco/qcw002.
[17] Van Hout B, Janssen MF, Feng YS, et al. Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets[J]. Value Health, 2012, 15(5): 708-715.
[18] Batóg P, Rencz F, Péntek M, et al. EQ-5D studies in cardiovascular diseases in eight Central and Eastern European countries: a systematic review of the literature[J]. Kardiol Pol, 2018, 76(5): 860-870.
[19] Dyer MTD, Goldsmith KA, Sharples LS, et al. A review of health utilities using the EQ-5D in studies of cardiovascular disease[J]. Health Qual Life Outcomes, 2010, 8(1): 13.
[20] 吴兆苏, 姚崇华, 赵冬. 我国人群脑卒中发病率、死亡率的流行病学研究[J]. 中华流行病学杂志, 2003, 24(3): 236-239.
[21] Pan A, Wang Y, Talaei M, et al. Relation of smoking with total mortality and cardiovascular events among patients with diabetes mellitus: a meta-analysis and systematic review[J]. Circulation, 2015, 132(19): 1795-1804.
[22] Mons U, Müezzinler A, Gellert C, et al. Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium[J]. BMJ, 2015, 350: 1551. doi: 1136/bmj.h1551.
[23] WHO. Global Strategy on Diet, Physical Activity and Health[EB/OL].[2020-01-11]. https://www.who.int/dietphysicalactivity/factsheet_adults/en/.
[24] John-Henderson NA, Counts CJ, Sanders CS, et al. Diminished cardiovascular stress reactivity is associated with lower levels of social participation[J]. J Psychosom Res, 2019, 118: 12-16. doi: 10.1016/j.jpsychores.2019.01.005.
[25] Lu J, Lu Y, Yang H, et al. Characteristics of High Cardiovascular Risk in 1.7 Million Chinese Adults[J]. Ann Intern Med, 2019, 170(5): 298-308.
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