成人特发性脊柱侧凸患者SRS-22简体中文版问卷评分的影响因素分析

Influence of demographic factors and radiographic parameters on simplified Chinese version of SRS-22 patient questionnaire performance in adult idiopathic scoliosis

中文关键词:  成人特发性脊柱侧凸  生活质量  脊柱侧凸研究协会22项（SRS-22）量表简体中文版  影响因素

英文关键词:Adult idiopathic scoliosis  Quality of life  The simplified Chinese version of SRS-22 questionnaire  Influence factor

中文摘要:

  【摘要】 目的：探讨临床及影像学参数对成人特发性脊柱侧凸患者脊柱侧凸研究协会22项（SRS-22）量表简体中文版问卷评分的影响。方法：2008年1月~2012年12月109例无支具及手术治疗史的成人特发性脊柱侧凸患者接受SRS-22简体中文版的问卷调查。男17例，女92例；年龄19~40岁，平均24.8岁。冠状面主弯Cobb角16°~102°，平均37.3°。分析SRS-22各维度得分及亚总分与年龄、体重指数、主弯Cobb角及矢状面平衡间的相关性，并分别比较年轻（＜30岁）与年长（≥30岁）、小角度（Cobb角＜40°）与大角度（Cobb角≥40°）、胸弯与胸腰/腰弯以及男性与女性患者间SRS-22评分差异。结果：年龄与SRS-22亚总分、疼痛、心理状况及功能维度得分负相关（r分别为-0.35、-0.50、-0.31、-0.21，P＜0.05）；体重指数与疼痛得分负相关（r=-0.23，P<0.05）；主弯Cobb角与SRS-22亚总分、自我形象及功能维度得分负相关（r分别为-0.31、-0.49、-0.30，P＜0.05）；矢状面平衡与功能维度得分负相关（r=-0.26，P<0.05）。年长患者SRS-22亚总分、疼痛及心理得分低于年轻患者（P＜0.05）。大角度患者SRS-22亚总分、自我形象及功能维度得分低于小角度患者（P＜0.05）。胸弯患者自我形象及心理维度得分低于胸腰/腰弯患者（P＜0.05）。女性患者的疼痛维度得分明显低于男性（P<0.05），其余参数及得分无统计学差异。结论：年龄、侧凸Cobb角、体重指数、躯干矢状面平衡可影响成人特发性脊柱侧凸患者SRS-22简体中文版问卷不同维度得分。胸弯患者自我形象及心理受侧凸的影响较腰弯患者更大，女性患者对疼痛的耐受性低于男性。

英文摘要:

  【Abstract】 Objectives: To investigate the influence of demographic factors and radiographic parameters on the simplified Chinese version of SRS-22 questionnaire in adult idiopathic scoliosis. Methods: From January 2008 to December 2012, 109 adult idiopathic scoliosis patients(17 males and 92 females) without a history of brace treatment or spine surgery completed the simplified Chinese version of SRS-22 questionnaire. The average age was 24.8 years(range, 19 to 40 years), and the average Cobb angle was 37.3°(range, 16° to 102°). Spearman correlation analysis was used to evaluate the correlation of SRS-22 domains with age, body mass index(BMI), Cobb angle and sagittal vertical axis(SVA). Comparisons were conducted in terms of SRS-22 subtotal scores and other domains with patient age(<30yrs vs. ≥30yrs), curve magnitude(<40° vs. ≥40°), curve pattern(thoracic vs. thoracolumbar/lumbar scoliosis) and gender. Results: Age was negatively correlated with SRS-22 subtotal scores, pain, mental status, function domain(r=-0.35, -0.50, -0.31 and -0.21, respectively. P<0.05). BMI was negatively correlated with pain domain(r=-0.23, P<0.05). Cobb angle was negatively correlated with SRS-22 subtotal scores, self-image and function domain(r=-0.31, -0.49, -0.30, respectively. P<0.05). SVA was negatively correlated with function domain(r=-0.26, P<0.05). Older adult patients had lower scores than younger adult patients in SRS-22 subtotal scores, pain and mental domain(P<0.05). Patients with large curve magnitude had lower SRS-22 subtotal scores, self-image and function domain than the patients with small curve magnitude(P<0.05). Patients with thoracic scoliosis had lower scores in self-image and mental domain compared with those with thoracolumbar/lumbar scoliosis(P<0.05). Female patients had lower pain domain score than male patients(P<0.05), but no difference was found in terms of other domains. Conclusions: Adult idiopathic scoliosis patients′ responses to SRS-22 questionnaire can be influenced by age, Cobb angle, BMI and sagittal balance. Patients with thoracic scoliosis present with poorer self-image and function than those with thoracolumbar/lumbar scoliosis. Female patients have lower tolerance of pain than male patients.