多发性硬化症患者生活质量的预测:躯体残疾、疲劳、认知障碍、情绪障碍、人格及行为改变

作     者：Benedict R.H.B. Wahlig E. Bakshi R. 张玉龙 

作者机构：Neurology D-6 Buffalo General Hospital 100 High Street Buffalo NY 14203 United States 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第8期

页      面：46-46页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：多发性硬化症 认知障碍 情绪障碍 生活质量 临床参数 临床测试 回归方法 职业状态 预测过程 职业状况 

摘      要：Health-related quality of life (HQOL) is poor in multiple sclerosis(MS) but t he clinical precipitants of the problem are not well understood. Previous correl ative studies demonstrated relationships between various clinical parameters and diminished HQOL in MS. Unfortunately, these studies failed to account for multi ple predictors in the same analysis. We endeavored to determine what clinical pa rameters account for most variance in predicting HQOL, and employ ability, while accounting for disease course, physical disability, fatigue, cognition, mood di sorder,personality, and behavior disorder. In 120 MS patients,we measured HQOL ( MS Quality of Life-54) and vocational status (employed vs. disabled) and then c onducted detailed clinical testing. Data were analyzed by linear and logistic re gression methods. MS patients reported lower HQOL (p 0.001) and were more like ly to be disabled (45%of patients vs. 0 controls).Physical HQOL was predicted b y fatigue, depression,and physical disability. Mental HQOL was associated with o nly depression and fatigue. In contrast, vocational status was predicted by thre e cognitive tests, conscientiousness, and disease duration (p 0.05). Thus, for the first time, we predicted HQOL in MS while accounting for measures from thes e many clinical domains. We conclude that self-report HQOL indices are most str ongly predicted by measures of depression,whereas vocational status is predicted primarily by objective measures of cognitive function. The findings highlight c ore clinical problems that merit early identification and further research regar ding the development of effective treatment.