Quality of Life and Its Influencing Factors in Han Nationality Patients with Polycystic Ovary Syndrome
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摘要:
目的 评价汉族多囊卵巢综合征患者生命质量并探讨其影响因素。 方法 采用方便抽样的方法，在云南省三级甲等医院妇科门诊及体检中心，选取163名汉族PCOS患者和194名健康女性作为研究对象。采用一般社会人口学和临床特征问卷、WHOQOL-BREF量表进行调查，以进行汉族PCOS患者生命质量现状及影响因素分析。 结果 PCOS患者和健康女性生命质量的生理领域和心理领域比较，PCOS组低于健康对照组，差异有统计学意义（P < 0.05）；PCOS患者生命质量得分为5.50～23.25（14.82±2.84）分。各维度得分由低到高依次是心理领域、环境领域、社会关系、生理领域；PCOS患者生命质量及各维度进行多元线性回归显示，PCOS患者生命质量及各维度受不同因素的影响，其中负性生活事件是影响生命质量及生理领域、心理领域的重要影响因素（P < 0.05）。 结论 PCOS患者生命质量降低，主要表现在心理健康状况降低，应关注PCOS患者的心理健康。为了提高PCOS患者生命质量，应重视患者的心理健康，注意对不同社会人口学和临床表现特征的患者采取个性化、有针对性的干预措施。 Abstract:Objective To investigate and evaluate the quality of life and its influencing factors in Han nationality patients with PCOS. Methods Convenient sampling methods were used.163 Han patients with PCOS who were diagnosed in gynaecological out-patient clinics and 194 healthy women were recruitedingrade Ⅲ-A hospitals of Yunnan Province. Sociodemographic characteristics questionnaire, clinical characteristics questionnaire and WHOQOL-BREF scale were used in the research. Results There were significant differences in the physiological and psychological fields between PCOS patients and healthy women in quality of life, and the PCOS group was lower with the healthy control group （P < 0.05）. The quality oflife score of PCOS patients were between 5.50 to 23.25, the average value was （14.82±2.84）, the score of each dimension from low to high was in order psychological, environmental, social relationship and physiological field. Multiple linear regression analysis showed that the quality of life and its dimension of PCOS patients were influenced by different factors, and the negative life events were the important factors influencing the quality of life as well as physiological and psychological fields （P < 0.05）. Conclusion The quality of life in PCOS patients was decreasing, which is mainly manifested in the decrease of mental health status. Therefore, attention should be paid to the mental health of PCOS patients and the personalized and targeted measures should be taken according to their social demography and clinical characteristics so as to improve their quality of life. -
Key words:
- Polycystic ovary syndrome /
- Quality of life /
- Influencing factors
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表 1 PCOS患者和健康女性生命质量及生命质量各维度得分的比较（
$ \bar x \pm s $ ）Table 1. Comparison of PCOS and healthy women score of quality of lifeand its dimensions （
$ \bar x \pm s $ ）组别 例数 生命质量 生命质量 生理领域 心理领域 社会关系 环境领域 PCOS组 163 14.82 ± 2.84 4.58 ± 0.89 2.56 ± 0.86 1.89 ± 0.42 4.79 ± 1.10 正常组 194 15.43 ± 3.09 4.78 ± 0.91 3.78 ± 0.91 1.96 ± 0.47 4.90 ± 1.19 t −1.923 −2.092 −2.390 −1.390 −0.963 P 0.055 0.037* 0.017* 0.165 0.336 *P < 0.05。 
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表 2 PCOS患者生命质量得分现状（
$ \bar x \pm s $ ）Table 2. PCOS quality of life score status （
$ \bar x \pm s $ ）维度 得分（分） 得分指标（%） 升序排列 生命质量 14.82 ± 2.84 − − 心理领域 3.56 ± 0.86 59.33 1 环境领域 4.79 ± 1.10 59.88 2 社会关系 1.89 ± 0.42 63.00 3 生理领域 4.58 ± 0.89 65.43 4
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表 3 不同特征PCOS患者生命质量及各维度的单因素分析（
$ \bar x \pm s $ ）Table 3. Comparisons of quality of life and its dimensions score of different characteristics of the patients with PCOS （
$ \bar x \pm s $ ）分组 例数 生命质量 t/Z P 生理领域 t/Z P 心理领域 t/Z P 社会关系 t/Z P 环境领域 t/Z P 文化程度 初中及以下 39 14.72±2.70 −0.258 0.797 4.55±0.95 −0.241 0.810 3.42±0.87 −1.180 0.240 1.94±0.41 0.707 0.481 4.81±0.93 0.176 0.860 高中/中专
及以上124 14.85±2.89 4.59±0.87 3.60±0.86 1.88±0.43 4.78±1.16 婚姻状况 未婚 78 14.60±3.03 −0.952 0.342 4.44±0.91 −2.018 0.045* 3.51±0.93 −0.691 0.491 1.85±0.39 −1.207 0.229 4.77±1.94 0.160 0.873 已婚 85 15.02±2.65 4.71±0.85 3.60±0.79 1.93±0.45 4.77±1.02 个人月收入 < 4250元 71 14.13±2.74 −2.782 0.006 4.46±0.85 −1.520 0.131 3.34±0.86 −2.939 0.004** 1.81±0.45 −2.171 0.031 4.52±1.09 −2.790 0.006** ≥4250元 92 15.35±2.81 4.67±0.90 3.73±0.82 1.96±0.39 4.99±1.08 家庭月收入 < 10000元 69 14.28±3.00 −2.108 0.037 4.51±0.97 −0.866 0.388 3.35±0.91 −2.680 0.008** 1.82±0.44 −1.873 0.063 4.59±1.17 −1.923 0.056 ≥10000元 94 15.22±2.66 4.63±0.82 3.71±0.79 1.95±0.40 4.93±1.04 负性生活事件 无 128 15.17±2.83 3.063 0.003 4.67±0.88 2.359 0.020* 3.67±0.86 3.262 0.001** 1.93±0.43 2.193 0.030 4.90±1.10 2.553 0.012* 有 35 13.55±2.51 4.27±0.85 3.15±0.73 1.76±0.39 4.37±1.05 超重 无 113 14.90±2.91 0.524 0.601 4.55±0.93 −0.607 0.545 3.63±0.88 1.671 0.097 1.90±0.39 0.485 0.628 4.81±1.11 0.359 0.720 有 50 14.65±2.70 4.65±0.79 3.39±0.80 1.87±0.49 4.74±1.11 多毛 无 112 14.97±2.91 0.972 0.332 4.67±0.87 2.339 0.021* 3.59±0.87 0.681 0.497 1.91±0.41 0.640 0.523 4.78±1.16 −0.133 0.894 有 51 14.50±2.68 4.34±0.90 3.49±0.85 1.86±0.45 4.80±0.98 痤疮 无 78 15.11±2.75 1.272 0.205 4.70±0.83 1.578 0.116 3.71±0.81 2.205 0.029* 2.00±0.43 1.023 0.308 4.78±1.08 −0.088 0.930 有 85 14.55±2.91 4.48±0.93 3.41±0.88 1.86±0.42 4.79±1.13 临床外在表现数量 无 45 15.12±2.64 1.238 0.293 4.51±0.83 1.658 0.194 3.73±0.77 3.138 0.046* 1.91±0.35 0.927 0.398 4.72±1.02 0.348 0.707 1种 62 15.04±3.14 4.59±0.93 3.63±0.95 1.94±0.46 4.88±1.25 2种及以上 56 14.34±2.62 4.43±0.88 3.33±0.79 1.83±0.44 4.74±1.01 月经紊乱 无 30 15.67±2.21 1.819 0.071 4.83±0.75 1.671 0.097 3.71±0.77 1.058 0.291 2.07±0.42 2.519 0.013 5.07±0.92 1.543 0.125 有 133 14.63±2.94 4.53±0.91 3.52±0.88 1.86±0.41 4.72±1.14 生育要求 无 83 14.74±3.05 −0.350 0.727 4.52±0.92 −0.924 0.357 3.57±0.92 0.166 0.869 1.84±0.39 −1.667 0.097 4.82±1.23 0.346 0.730 有 80 14.90±2.62 4.65±0.85 3.55±0.80 1.95±0.45 4.76±0.96 不孕 无 103 14.85±2.89 0.199 0.843 4.56±0.88 −0.432 0.666 3.56±0.89 −0.048 0.962 1.89±0.41 −0.038 0.970 4.85±1.12 0.912 0.363 有 60 14.76±2.77 4.62±0.92 3.56±0.82 1.90±0.45 4.68±1.07 诊断为PCOS时间 初次确诊 47 15.51±2.89 2.415 0.093 4.66±0.93 0.287 0.751 3.84±0.87 4.470 0.013* 1.97±0.40 1.430 0.242 5.04±1.08 2.653 0.074 ≤1年 50 14.82±2.71 4.53±0.92 3.56±0.85 1.91±0.43 4.84±0.94 > 1年 66 14.33±2.84 4.57±0.85 3.36±0.82 1.83±1.08 4.57±1.20 家庭关系 不好 4 10.05±2.33 6.345 0.002 4.00±0.46 0.934 0.395 2.81±0.77 3.029 0.0518* 1.19±0.52 7.760 0.001 2.50±1.00 12.672 < 0.001*** 一般 11 13.70±2.96 4.66±0.98 3.16±0.88 1.70±0.31 4.18±1.03 很好 148 15.05±2.75 4.60±0.89 3.61±0.85 1.93±0.41 4.91±1.03 *P < 0.05；**P < 0.01； ***P < 0.001。
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表 4 变量赋值表
Table 4. Variable assignment table
变量 变量赋值 文化程度 X1 初中/中专及以下 = 1；
高中/大专及以上 = 2婚姻状况 X2 未婚 = 0；已婚 = 1 个人月收入 X3 < 4250元 = 1；≥4250元 = 2 家庭月收入 X4 < 10000元 = 1；≥10000元 = 2 负性生活事件 X5 无 = 0；有 = 1 超重 X6 无 = 0；有 = 1 月经紊乱 X7 无 = 0；有 = 1 不孕 X8 否 = 0；是 = 1 诊断为PCOS时间 X9 初次确诊 = 0；1 a = 1；> 2 a = 2 痤疮 X10 无 = 0；有 = 1 多毛 X11 无 = 0；有 = 1 临床表现外在数量 X12 无 = 0；1种 = 1；≥2种 = 2 家庭关系 X13 不和谐 = 0；一般 = 1；和谐 = 2
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表 5 影响生命质量因素的多元线性回归分析
Table 5. Multiple linear regression analysis on influencing factors of quality of life in PCOS
自变量 偏回归
系数标准误 标准回归
系数t P 常量 8.98 1.74 − 5.17 < 0.001*** 家庭关系 1.52 0.55 0.21 2.76 0.006** 个人月收入 1.10 0.43 0.19 2.59 0.001** 负性生活事件 −1.22 0.52 −0.18 −2.33 0.021* *P < 0.05；**P < 0.01；***P < 0.001。（自变量中，以家庭关系不和谐 = 0；个人月收 < 4250元 = 1；无负性生活事件 = 0为参考变量）
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表 6 影响生理领域因素的多元线性回归分析
Table 6. Multiple linear regression analysis on influencing factors of physiological domain in PCOS
自变量 偏回归
系数标准误 标准回
归系数t P 常量 4.62 0.11 − 40.98 < 0.001*** 多毛 −0.33 0.15 −0.17 −2.24 0.026* 婚姻状况 0.29 0.14 0.16 2.13 0.035* 负性生活事件 −0.42 0.16 −0.20 −2.58 0.011* *P < 0.05；**P < 0.01；***P < 0.001。（自变量中，以无多毛 = 0；未婚 = 0；无负性生活事件 = 0为参考变量）
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表 7 影响心理领域因素的多元线性回归分析
Table 7. Multiple linear regression analysis on influencing factors of physiological domain in PCOS
自变量 偏回归
系数标准误 标准回
归系数t P 常量 3.59 0.25 − 14.63 < 0.001*** 负性生活事件 −0.47 0.15 −0.23 −3.14 0.002** 诊断为PCOS时间 −0.23 0.08 −0.22 −3.09 0.002** 个人月收入 0.34 0.13 0.20 2.76 0.007** 临床外在表现数量 −0.19 0.08 −0.18 −2.43 0.016* *P < 0.05；**P < 0.01；***P < 0.001。（自变量中，以无负性生活事件 = 0；诊断为PCOS时间 = 初次诊断；个人月收 < 4250元 = 1；无临床外在表现数量 = 0为参考变量）
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表 8 影响社会关系因素的多元线性回归分析
Table 8. Multiple linear regression analysis on influencing factors of physiological domain in PCOS
自变量 偏回归
系数标准误 标准回归
系数t P 常量 1.19 0.25 − 4.77 < 0.001*** 家庭关系 0.29 0.08 0.27 3.64 < 0.001*** 月经紊乱 −0.18 0.08 −0.17 −2.23 0.027* *P < 0.05；**P < 0.01；***P < 0.001。（自变量中，以家庭关系不和谐 = 0；无月经紊乱 = 0为参考变量）
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表 9 影响环境领域因素的多元线性回归分析
Table 9. Multiple linear regression analysis on influencing factors of environmental domain in PCOS
自变量 偏回归
系数标准误 标准回归
系数t P 常量 1.29 0.63 − 2.04 0.043* 个人月收入 0.44 0.16 0.20 2.71 0.008** 家庭关系 0.98 0.20 0.35 4.78 < 0.001*** *P < 0.05；**P < 0.01；***P < 0.001。（自变量中，以个人月收 < 4250元 = 1；家庭关系不和谐 = 0为参考变量）
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