QOL的临床意义探讨——以心脑血管疾病为例

With the change of diet structure and the acceleration of the aging process, cardiovascular and cerebrovascular diseases have become a global health problem, it has serious threat to people's health. With the transformation of disease spectrum and the medical model, the quality of life(QOL) has become an important index of health assessment, and it can express health connotation preferably.because the quality of life pays more attention to the patients' subjective feeling, how to combine the assessment of quality of life with traditional clinical indexes has become the focus. This research focuses on QOL status and its impact factors of patients with cardiovascular and cerebrovascular disease ; At the same time ,the relation between QOL and the routine clinical parameters 、interpretation of QOL scores、minimal important clinical difference (MID)、the impact on QOL in molecular genetic mechanism will be discussed ; Finally, the different between different treatment will be compared by QOL. This study not only has important significance for improving quality of life in patients with cardiovascular disease ,but also broadens the new research areas in the quality of life by the study on the relation between QOL and clinical indexes、biological information.

生命质量（QOL）已成为健康评估的重要指标，QOL更注重患者的主观感受，如何把QOL评价与传统的临床指标结合起来已成为大家关注的焦点，却鲜有报道。心脑血管疾病已成为严重威胁人类健康的、全球性的健康问题。本研究将以心脑血管疾病为例，探讨QOL这一指标的临床应用价值。 本研究主要内容有：心脑血管疾病患者的QOL现状及影响因素；重点探讨QOL与临床常用客观指标间的关系、QOL得分的解释与临床意义，探讨制定临床最小显著差异（MID）；以QOL为结局指标比较不同治疗方法的疗效；对影响QOL的分子遗传机制进行初步探讨。 本研究的成果可用于提高心脑血管疾病患者的QOL。同时，从QOL与临床指标、生物信息等的关系方面进行研究，将进一步拓宽QOL研究的范围。

随着人口老龄化进程的加速，严重威胁人类健康的心脑血管疾病已成为一个全球性的健康问题。随着疾病谱和健康模式的转变，生命质量（QOL）已成为健康评估的重要指标，其更能表达健康的内涵。由于QOL更注重患者的主观感受，如何把QOL评价与传统的临床指标结合起来已成为大家关注的焦点。本研究运用自制量表QLICD-HY、QLICD-CHD、 QLICD-ST分别对高血压、冠心病、脑卒中患者进行生命质量测定，采用相关分析、多重线性回归、多元逐步回归等统计学方法探讨生命质量得分与临床指标间的关系、生命质量的影响因素。根据分布法，取ES为0.5，制定高血压MCID为：生理功能领域4.96、心理功能领域7.26、社会功能领域4.67、共性模块总分领域5.13、特异模块领域6.68、量表总分领域4.99；脑卒中MCID为：生理功能领域5.50、心理功能领域6.09、社会功能领域6.01、共性模块总分领域5.51、特异模块领域5.14、量表总分领域5.06；冠心病MCID为：生理功能领域1.36、心理功能领域8.62、社会功能领域7.96、共性模块总分领域8.82、特异模块领域7.04、量表总分领域9.14。探讨QOL与临床常用客观指标之间的关系，一定程度上拓宽了QOL的研究领域范围；制定QOL应用的临床最小显著差异值，提高了QOL这一指标在临床上的应用性；了解心血管疾病患者QOL现状，探讨其主要影响因素，提高了临床干预的针对性。