$6 1 -2013 TAP CHl PHONG C H 6 N G BENH S6I R^T VA CAC BgNH KY SINH TRUNG 3_
NGHIEN c u t ! ANH HlTdNG CIJA BENH PEMPHIGUS DEN
C H A T
LirONG CUOC
S 6 N GNGlTdl BENH 2012 TAI BENH VIEN DA LIEU TRUNG UONG
Cao Ba Lyi', C^n XuSn Lu•o•ng^ Nguyen Thdi DOng^, Tr^nLan Anh, Nguyin Thj Minh H o a S d CS
Tom tat:
Mot nghien ciht da duac tiin hanh nam 2012 tgi Benh vi^n Da lieu Trung uang. Co 62 binh nhdn dS dwcrc phong vdn nham phdn lich. ddnh gid nhiing dnh hudng cua h^nh Pemphigus den chdt luring cuoc sdng ngudi b^nh, kit qua cho thdy:
Co 65,0% so b$nh nhdn co tri^u chung rdt dau, nhirc, ngua. 90,0% so b^nh nhdn cho rdng CO dnh huang rdt nhiiu tdi CUQC song hdng ngdy ciia ngudi h^nh nhu: Cdc hogt dqng mua sdm, cham soc nhd cua 89.0%, co dnh hu&ng rai nhieu lai Irang phyc cua ngudi b^nh. 70.5% dnh hudng rdi nhieu t&i sinh hogt vd ihi due the thao. 79,0% dnh hu&ng rdi nhieu l&i cong viec vd hQC tap, 79,0% bi nguai than vd gia dinh xa lanh, phdn hi^t doi xu. Co 100,0% so b4nh nhdn cho rdng CO dnh hu&ng cdc miec do khdc nhau den d&i song tinh due trong do: Mac cdm trong sinh hogt tinh due 33,0%, e nggi trong sinh hogt tinh due 4J,5.0%, gidm hi'mg thu 25,5%. Benh Pemphigus gdy mdt nhieu th&i gian. Ion nhieu tiin, dnh hu&ng din ngu&i thdn trong gia dinh.
thay doi sinh hogt cua bdn thdn v&i cdc ty le tuang img 92,5%, 90,0%, 80,0% vd 98,7%.
Tic khoa: Pemphigus - Chdt luang cuoc song.
1. D ^ T V A N D E
Pemphigus la benh da co bong nuac tu miln vol ton thuang dac trung la bpng nucrc 6 da va ni€m mac gSy ra do hien tucmg ly gai (acantholysis). BSng miln dich huynh quang trurc tiSp ngirai ta thay co sir lang dong IgG a khoang gian bao giua cac te bao simg. BSnh tuong d6i hiem gap, phan bo khip ThS gi6i, khac nhau r6 r?t ve ty 1§ m i c (TLM) 6 cdc viing va cac the trong nhom Pemphigus [5], [6], [7], [10], [13].... Ti 1? mdc b?nh thay ddi tO- 0,S -0,34/
trieu nguoi/nam [11], [12], [15]. Theo tai lieu cua Truong Dai hpc Y Ha Npi benh Pemphigus a nirac ta khoang 0,74-0,8% tren long so ca benh da lieu [1], [2], [14].
Ve phan loai Pemphigus, co nhieu each, tuy nhien theo lam sang, da s6 cac tac gia phSn nhom benh Pemphigus thanh 4 th^ benh: Pemphigus thong thuong; Pemphigus siii;
Pemphigus vay la; Pemphigus ban dd [1], [2], [8], [9]..
' Vi^n S6t r^t- KST- CTTU
• B^nh vien Da lieu TU'
^ Trung tam Da lieu tinh Ngh| An
* D?i hpc Y Hai Ph6ng
4 S6 1-2013 T»P CHi PHONG C H 6 N G BENH S6T RET VA CAC BJNH K^ SINH TRUNG
Nghien cim ve b$nh Pemphigus tsii Vi?l Nam n6i chung v4 nghi6n cto cdc dnh huong d^n chat lu(7ng cupc s6ng ngu-^i b$nh b^nh n6i riSng cho dSn nay c6n rat it 6i, chi c6 mpt so it Ah tdi nhir: Ph^im Anh Tuyet (1974), th6ng bdo m^t tmdng hpp mic b$nh Pemphigus 6 phu nO c6 thai, Ph?m Die Ngpc (1977), nghiSn oCtu v^ djch te hpc, ldm sdng, can lam sdng cua b?nh Pemphigu.i Vulgaris. Timsothea (2001), nghien cihi t?i Vipn Da lieu Trang uong giai do?n 1995 - 2000 [3], [4], Theo Vi^n Da lilu Trang uong do 6 nhiem moi truong song, trong nhiing ndm g ^ day ty 1$ bf nh Pemphigus dang c6 xu hudng tdng cao trong cpng dong dan cu cd V j ty 1? mdc b?nh va tu6i trung blnh phdt b^nh gdy hdu qud xdu d^n siic kh6e thS chat vd tinh thdn ngudi b^nh, Xuat phdt tit thvrc t6 dd chiing tdi tien hdnh nghien ciiu dS tdi: Nghien ciiu iinh huihig ciia benh Pemphigus den chit lufng cu^c sSng nguM Hnh 2012.
2. PHU'ONC. PII.AP NGHlfeN c i r u
2.1. Ooi tu-p'nt> vd dia dicm, thdi gian nghicn cl^u 2,1,1 Dni tu'o'ng nghien cu'u
Benh nlian dang dieu trj benh Pemphigus, 7,1,2, Dia diem nghien cii-u
Benh vien Da lieu Trung uong, 2,1.3 Thdi gian nghien cihi
Tir thdng 3/2012 - thdng 09/2012 2.2. Cd mau nghien cihi
LTng dung cdng thuc tinh cd mdu tdi thieu cho dieu tra mdt ty le hien mdc:
P i l - P )
Trong d6: n: C& mlu toi thieu; p: Ty le bieu hien 13m s^g di6n hinh nhu dau, rdt, ngua, chpn p = 0,80 (80%), thi q = 1- p = 0,2 (20%); Zj.^.^: H? s6 tin cay, img voi dp tin cay 95%
thi Z,_^,2= 1,96; d: Sai so tuyet doi mong muon, chpn d = 10 % (d = 0,1).
Vai cac gid tri da chpn vd de tdng do tin cay cua nghien cuu chung toi cpng them 5%
vao c5 mau dieu tra phong van 62.
2.3. Cac chi so vd phirotig phdp ddnh gid dnh hirovg cua bfnh Pemphigus den chit lirang cupc s6ng cua ngiroi bfnh
2.3.1 Cdc chi s6 ddnh gid
Cac chi s6 vt thdn kinh tdm ly ngu&i benh nhu: Lo au, bu6n phien...; Cac chi s6 vS kh6 khdn trong sinh hoat nhu: Ngiia - nhiic nh6i kho chiu, gay cdn tro trong hpc tap, c6ng tdc va
S6 1-2013 TAP CHi P H 6 N G C H 6 N G B|NH S6T RfeT VA CAC BgNH KY SINH TRpNG 5_
hoat d^ng th6 thao, ngugng ngdp xau ho - mk ty tin ho^c ngai ra duong trdnh xuat hipn a dam ddng, kh6 khdn trong m§c qudn do, bj ngu6i than vd ban bh xa Idnh hodc phdn bi?t ky thi...; Cdc chi s6 ddnh gid tinh tr^g kh6 khdn trong sinh ho^t vp ch6ng.
2.3.2 Phu'Ong phdp ddnh gid
- Nhdm giup mpi ngu6i c6 thg xdc djnh t^ing thdi t6t hay x^u cua ch^t lupng cupc s6ng ngufii b|nh, chiing toi ve ra m^t thang difim gidng nhu nhi^t k^. C thang diem ndy:
+ So di&n 100 tuong ling v6i tinh tr^g siic kh6e tot nhat.
+ 0 diim tuong ling v6i tinh tr^ng siic kh6e xdu nhat md anh chj c6 thi hinh dung dupc.
+ Ngudi b?nh tyr ddnh gid vd dien vdo gid trj tren thang diem (chung toi mong muon anh (chi) s6 chi ra tren thai^ di6m ndy tinh trang siic kh6e tot hay xdu ciia minh ngdy horn nay. Xin hdy vg mpt dudng k6o ngang tCr 6 td den ben dinSi den diim ma anh chj cho Id thich ling nhdt vdi tinh trang siic khde cua minh hdm nay?)..
Cdch ddnh gid dnh hudng cua b^nh Pemphigus den chat lupng cupc sdng ciia ngudi bSnh chiing toi dua vao bdng cau hdi danh gid vd cho diem cua Finlay, nhu sau:
- Tri$u chiing vd cam giac (cau hdi 1 va 2): Diem tdi da Id 6 - Hoat dpng hang ngdy (cau hoi 3 va 4): Diem toi da la 6 - Thdi gian ranh (cau hoi 5 va 6): Diem tdi da la 6 - Cdng viec va hpc t|,p (cau hdi 7): Diem toi da la 3 - Cdc moi quan hp cd nhan (cau hdi 8 va 9): Diem toi da la 6 - DiSu tri (cau hdi 10): Diem toi da Id 3.
Cach tinh diem: Dem ddnh gia cho mdi cdu hdi Id:
Bdng 1. Cdch ddnh gid cho diem cdc ven de dnh hudng den chdt lupng cupc sdng ngudi b$nh Mu'C d$ anh hirdng
Rat nhieu Nhieu ft
KJidng chiit nao Khdng hoan todn Khdng lien quan Khdng tra ldi
S^ diem : 3 diim [RN (3d^)]
: 2 diem [N (2d')]
: 1 diSm [I ( I d ' ) ]
; Odi^m"[K(Od')]
: 0 didm [K (Od^)]
: 0 didm [K (Od')]
: 0 didm [K (Od')]
6 S6 1 -2013 TAP CHi P H 6 N G C H 6 N G BgNH S6T RET vA CAC BJNH KY SINH TRUNG
Quy dinh ddnh gid mire dp dnh hudng din chdt lupng cupc sdng, dva vdo tdng so diim cua benh nhdn cd dupc md ddnh gid mire dd dnh hudng: Anh hudng rit nhiiu: tit 20 - 30 diSm; Anh hudng nhieu: tit 10 -19 diim; Anh hudng it: tir 1 - 9 diim; Khdng dnh hudng: 0 diim.
Ting diim tii da Id 30 vd toi thieu Id 0, diim cdng cao thi chit lupng cu$c song cdng gidm (nghla Id b$nh dd cd dnh hudng nhiiu den chit lupng cu$c sing ngudi b?nh),
Trong cdch cho diim ndy: Niu cd 1 cdu nhdn thtic sai thi tinh diim 0 vd phiiu dieu tra vdn dupc tdng kit. Niu cd > 2 cau hdi nhdn thirc sai thi phiiu diiu tra khdng dupc tong kit Niu cau hdi 7 dupc trd ldi -'cd", thi tinh 3 diim, niu trd ldi "khdng" hay "tuong ddi khdng"
nhung sau dd l^ii vira "if vira "nhiiu" thi tinh 2 hay 1 diim, Neu cd hem 2 muc dupc trd ldi dupc ddnh diu thi myc cd s6 diim cao nhit dupc lya chpn. Niu cdu trd ldi ndm giCTa 2 myc ddnh diu, thi myc cd s6 diim thip hem se dupc tinh.
Bdng cdch cho diim ndy cd the ddnh gid dnh hudng cim b$nh Pemphigus Tdi chit lupng cupc song d dang ty 1$ (%). Vdi nhihig ty 1? (%) dnh hudng rit nhieu, dnh hudng nhieu, it anh hudng vd kiidng dnh htrdng.
2.3.3, Xu- ly so lieu
Cac sd lieu thu thap trong nghien cira, dupc xir ly theo phuang phdp thdng ke y, sinh hpc va sir dyng phdn mim Epilnfo 6,04, Stata 12.0,
2.3.4, Dao dire nghien cihi
Tudn thii cdc qui dinh trong nghien ciiu y, sinh hpc nhu: Trudc khi phdng vdn, kham benh, liy mau benh phim dii tupng nghien cu'u phdi dupc thdng bdo vd ndi rd myc dich nghien cthi. Giii bi mat cho ngudi benh va chi nghien ciiu d ngudi ty nguydn.
3. KET QUA NGHIEN CtTU
3,2, Ddnh gid anh hydng cua b^nh Pemphigus den chit lupng cu$c sing cua ngvdi bfnh 3.2.1. Anh hudng ciia b?nh Pemphigus din cdc trieu chimg cdm gidc dau, nhuc, ngiia
Bdng 2. Anh hudng ciia bdnh Pemphigus din cdc tii6u chimg cdm gidc dau, nhilc, ngua
Chi tiSu ddnh gid
Cac tri$u chimg dau, nhiic, ngiia Gia tri trung binh
Gid tri p
Mirc dp anh hirdmg Rat nhiiu
n 41
Tyl?
(%)
65,0 Nhieu n 19
Tylp 30,0
it n 3
Ty le
(%)
5,0
KhSng AH n 2
Tyl?
(%)
3,0 24,0 ± 4,9
p(l:2;3;4)<0,01; p (2: 3;4)>0,05
S 6 1-2013 TAP CHi:PH6NG CH6NG'BgNH S 6 T RET VA C A C BENH KY SINH TRUNG
Nhgn xet:
Co 65,0% (41/62) sd b$nh nhan cho rdng b?nh Pemphigus dnh hudng rat nhiiu tdi cdc tri?u chiing dau, nhiic vd ngiia. Chi c6 30,0% (19/62) so b?nh nhan cho rdng b?nh Pemphigus dnh hudng nhieu den cac trieu chiing dau, nhiic va ngiia.
3.2.2 Anh huwng c&a bfnh Pemphigus d^n tinh than, tam 1^ xd hpi cua ngirfii b^nh Bang 3. Anh hudng ciia b$nh Pemphigus den tam ly xd hpi ciia ngudi b^nh
Chi tigu ddnh gid
Lo au, budn phien Gid tri tnmg binh Gid tri P
Chan nan, bit luc trudc benh tat Gid tn trung binh Gid tri p
Tinh thdn suy sup budng xudi Gid tri trung binh Gia tri p Chung Gid tri tnmg binh Gid trip
Md-c d$ dnh hudng Rit nhiiu
n 56
(%)
90,3 Nhiiu n 6
(%)
9,7 it
n 0
(%)
0
Kh6ng AH n 0
(%)
0 28,0 ± 7,6
p(l:2;3;4)<0,01; p (3: 4) > 0,05
58 93,5 3 4,8 1 1,3 0 0
27,0 ± 5,4
p(l:2;3;4)<0,01; p (2: 3; 4) > 0,05
46 74,0 16 26,0 0 0 0 0
23,0 ± 5,6
p(l:2;3;4)<0,01; p (2: 4)> 0,05
57 93,0 4 6,0 1 1,3 0 0
28,1 ±7,8
p(l:2;3;4)<0,01; p(3:4)>0,05 Nhdn xet:
Ty 1$ benh nhan trd ldi r^ lo du, budn phi^ rdt cao 90,3%, Chan ndn, bit l\rc, trudc b?nh tdt tdi 93,5% va tinh thdn guy xyp buong xudi 74,0%. Ddc bi?t khdng cd bit cii b?nh nhan ndo (0,0%) trd ldi d ca ba cdu hdi: Khdng lo du, budn phien; Khdng chdn nan, bdt luc trudc b$nh tdt vd Tinh thdn suy xup budng xudi.
^ S6 1 -2013 TAP CHi P H 6 N G C H 6 N G BgNH S6T RJT VA CAC BJNH KY SINH TRUNG
Bdng 4. Anh hudng din tdm ly ngudi b$nh bii rdi, m^c cdm, ngai giao tiip vd ng?i xuit hi^n trudc ddm ddng
Chi tieu ddnh gid
Anh huong din tam ly ngudi b?nh Gid trj trung binh
Gid tri P
Miic d$ anh hirdng Rat nhieu
" i
50
(%)
80,5 Nhiiu
" 2
10
(%)
18,2 it
n^
2
(%)
1,3
Khong AH n
0
(%)
0 26,9,0 ± 7,4
p(l:2;3;4)<0,01; p(2: 3; 4)>0,05 .\lhiii .xef.
Co 80,5% (50/62) sd benh nhdn cho rdng b?nh Pemphigus dnh hudng rdt nhieu tdi tdm 1< ngudi benh.
Co sy khac biet giu^ sd b?nh nhan cho rdng b?nh Pemphigus dnh hudng rdt nhifiu tdi tam ly ngudi benh vdi anh hudng rat it vd khdng anh hudng vdi cdc gid tii {80,5%o so vdi 18,2%, 1,3% va 0,0% vdi p < 0,01), Khdng cd benh nhan ndo cho rdng khdng c6 dnh hudng cua benh Pemphigus tdi tam ly ngudi b?nh.
Bang 5. Ngudi b?nh cam thay ngugng, xau hd vd mat ty tin trong cupc sdng
Chi tieu danh gid
Ngupng, xau hd, mat ty tin trong cupc sdng vi benh P.
Gia trj trung binh Gid tri p
Mirc dp dnh hudng Rit nhieu
n 59
(%)
95,0 Nhieu n 3
(%)
5,0 it n 0
(%)
0
Khong AH n 0
(%)
0
26,9,0 ± 7,4 P( :2;3;4)<0,01, p (2: 3; 4) > 0,05 Nhdn xel:
Cd 95,0% (59/62) s6 ngudi dupc hdi trd ldi rit ngupng, xiu hd vd mit ty tin tix)ng cu§c sdng, trong khi chi cd 1,0% trd ldi khdng ngupng, khdng xiu hd, khdng mit ty tin trong cupc sdng, Khdng cd sy khac bi?t vi sd b?nh nhdn tra ldi cd dnh hudng it vd khdng dnh hudng (0%
va 0%; vdi p > 0,05).
S6 1-2013 TAP CHl PHONG C H 6 N G BgNH S6t RfeT VA CAC BgNH KY SINH TRUNG 9^
3.2.3 B^nh Pemphigus ldm tr* ng?i trong cu§c s^ng hdng ngdy cua nguiri bfnh nhir: Mua sdm, chdm sdc nhd cihi...
Cdc dnh hudng ldm trd ngai trong cuOc s6ng thudng ngdy cua ngudi b^nh bao g^m: Mua sdm, cham sdc nhd ciia
OAnh hu'd'ng r^l nhi^u
• Anh huijng nhi^u D C 6 anh hirong il
Hinh 1. Anh hudng cua b?nh Pemphigus tdi cdc hoat dpng mua sdm, chdm sdc nhd ciia, ldm vi^c nha Nhgn xet:
Co 90,0% so benh nhan tra ldi b?nh Pemphigus anh hudng rat nhieu tdi cu$c song nhu mua sdm, chdm sdc nha ciia vd gia dmh. Cd 0,0% sd benh nhan dupc hdi tra ldi khong dnh hudng.
3.2.4 Anh hu-orng ci^a benh Pemphigus d^n: Trang phuc, lu-a ch9n ki^u each, kinh c&, mdu sac...
Bang 6. B6nh Pemphigus dnh hudng d6n trang phuc cua benh nhan
Chi tieu danh gia
Anh hudng din trang i^uc ciia ngudi benh Gia tri trung binh
Gid tri p
Anh hudng den trang phuc Rat nhieu
n 55
(%)
89,0 Nhieu n 5
(%)
8,0 it
n 2
(%)
3,0
Khong AH n 0
(%)
0 23,0 ± 5,4
p(l:2;3;4)<0,01; p (2: 3; 4) > 0,05 Nhgn xet:
89,0% s6 ngudi cho ring b$nh Pemphigus dnh hudng rit nhiiu tdi trang phyc, Cd su khdc bi$t giira sd b$nh nhan cho rdng binh Pemphigus dnh hudng rit nhiiu, dnh hudng nhiiu, drih hudng it vd khdng dnh hudng din trang phuc vdi 89,0% so vdi 8,0%, 3,0%
vd 0,0% vdi p < 0,01, " •
10 S6l-2013 TAP CHi PH6NGCH6NGBgNHS6TR6TVA CAC 6|NHK<'SINH TRUNG 3,2.5 Anh hirdng cua b^nh Pemphigus den cdc hoat dpng xd hpi hay giai trl
S,7"/.
S(),5"/,
Hinh 2. Ty le dnh hudng ciia benh Pemphigus tdi ho?it ddng xd hpi Nhdn xet •
Tong so cd 100,0% so benh nhdn dupc phdng vin trd ldi c6 dnh hudng din hoat dpng xd hpi d cdc muc dp khdc nhau, trong dd: Cd 80,5% (49/62) b?nh nhdn dupc hdi ud ldi dnh hudng rit nhiiu tdi boat dpng xa hoi, 10,8% (7/62) si b?nh nhdn trd ldi dnh hudng nhiiu tdi boat dpng xd hpi. 8,7% (6/62) trd ldi khdng dnh hudng din boat dpng xd hdi,
3.2,6 Anh hudng cua bfnh Pemphigus tdi ho^t dpng thi dye the thao
11,5%
TO,?'/..
Hinh 3, Ty 1? dnh hudng cua b$nh Pemphigus tdi ho^it dpng thi dpc thS thao Nhdn xet:
Tdng so cd 100,0% si b$nh nhdn dupc phdng vanttaldicd dnh hudng din ho?t d^ng thi due thi thao d cdc miic dp khdc nhau, trong dd: Cd 70,5% (44/62) benh nhan duprc hdi tid ldi dnh hudng rat nhieu tdi hoat dpng the d\ic thi thao.l 1,0% (7/62) so benh nhan trd ldi dnh I nhiiu tdi hoat dpng thi dye thi thao, 19,5% (11/62) cho ring khdng dnh hudng din ho^
thi due thi thao.
1
S6l-2013 TAP CHi PHONG C H 6 N G B | N H S 6 T RET VA CAC BENH KY SINH TRUNG H
3,2.7 Anh hudng cua b?nh Pemphigus den cdng vi^c vd hpc t^p
Bang 7, Anh hudng cua benh Pemphigus din cdng vipc vd hpc tdp cila ngudi b?nh
Chi ti@u ddnh gid
Benh nhan P.
Gid tri trung binh Gid hi p
Mij'c d$ dnh hudng Rat nhiiu
n 49
(%)
79,0
Nhiiu n 7
(%)
11,5 it n 6
(%)
9,5
KhSng n 0
(%)
0,0 23,0 ±5,4
p(l:2;3;4)<0,01, p (2: 3; 4) > 0,05 Nhgn xet:
Co 79,0%o (49/62) sd benh nhan cho rdng benh P. dnh hudng rdt nhi^u tdi cdng vi$c vd hpc tap, cd 11,5% (7/62) sd b?nh nhan cho rdng cd dnh hudng nhidu tdi khd nang ldm vi?c vd hpc tap, 9,5% (6/62) sd benh nhan cho rdng cd dnh hudng it tdi khd ndng ldm viec vd hpc tap cua ngudi benh.
3.2.8 Anh hiromg cua bSnh Pemphigus den cdc moi quan h€ b^n be, hang xom, ngiroi thdn cua ngiroi benh
Bang 8. Ngudi b6nh Pemphigus bi hang xom, ngudi than xa Idnh, phdn biet ddi xii
Chi tiSu danh gid
Bi hdng xdm, ngudi thdn xa Idnh, phdn biet doi xii Gia tri trung binh Gia trip
Mii-c dd anh hirdng Rit nhiiu
n 49
(%)
79,0
Nhiiu n 0
(%)
0 it n 0
(%)
0
Khdng n 13
(%)
21,0
23,0 ±5,4 P (1:2;3;4)<0,01, p (2: 3) > 0,05 ndT Nhdn xet:
Sd benh nhdn bi ngudi than xa lanh Id 79,0% (49/62), c6 21,0% (13/62) sd benh nhdn trd ldi khdng bi hi ngudi than xa lanh.
12 S6 1 -2013 TAP CHi PHONG C H 6 N G BgNH S6T RET VA CAC B JNH K'j SINH TRUNG
21,0% 7^^"%
DBIngufrillian DKhOng b, mju.
Hinh 4, Ty 1^ ngudi mdc b?nh bi hdng xdm, ngudi thdn xa Idnh, phdn biit dii xu Nhdn xii:
Cd 79,0% si ngudi dupc phdng vin trd ldi bi ngudi thdn xa Idnh vd 21,0% s6 ngudi trd Idi khdng bi bi ngudi thdn xa Idnh.
3.2.9 Anh hudng cua b?nh Pemphigus din mii quan h | cd nhan nhu: GSy khd khin trong quan hf tinh dye cua ngudi bfnh (e ngjii, mdc cdm, gidm hung thii)
Bdng 9, Bfnh Pemphigus gdy dnh hudng din ddi sing tinh dvc cua ngudi bfnh
Chi tieu ddnh gid
Anh hudng din sinh ho^t tinh dye Gid tri tnmg binh Gid trip
Anh hucing din sinh hoat tinh dfc Mdc cdm
n
20 Tyl?
(%)
33,0
Engji
n
24 Tylf
(%)
41,5
Giim hihig thii n
18 Tyli
(%)
25,5
Khdng AH
n
0 Tylf
(%)
0
20,0 ±3,4
p(l:2;3;4)<0,01; p (2: 3;4)>0,05 Nhdn xet:
Ty 1? bfnh nhan trd ldi mdc cam trong sinh ho^t tinh due 41,5%, e ng^ trong sinh ho^t tinh dye 33,0%, gidm hdng thu 25,5%.
Cd sv khdc bift vi ty If bfnh nhdn trd ldi mjc cdm trong sinh host vd e ngp vd gidm hiing thll trong sinh hoiit tinh dye, 41,5% so vdi 33,0% vd 25,5% vdi p < 0,05.
3.2.10 Anh hudng ciia vlfc dilu trj bfnh Pemphigus gdy khd khdn cho ngirdi bfnh (nhu: Tdn tiin cia, bin nhd ciia ho^ mit thi gid, thay dii smh ho?t ciia bdn thdn)
Cdc dnh hudng cua vifc diiu tri bfnh thi rit nhiiu, trong dd cd rn$t s6 yeun ti co bdn nhu: ton tiin cua, bin nhd cda hodc mat thi gid, thay dii sinh hoat ciia ban thdn,..
'1-2013 TAP CHi PHONG C H 6 N G BJNH S6T RET VA CAC BfNH KY SINH TRUNG 13 Bang 10. B6nh Pemphigus mdt nhieu thdi gian, ton nhiSu tihn, ldm dnh hudng den ngudi than
trong gia dinh, thay ddi sinh hoat cua ban than ngudi b?nh Cdc dnh hudng cua bfnh den ban than ngudi bfnh vd gia dinh Mat nhiiu
thdi gian Si PV 62
Trd ldi cd 57
Ty le (%) 92, 0
Ton nhieu tien Sd PV 62
Tra ldi cd 56
Ty If (%) 90,0
Anh hudng den ngudi thdn So PV 62
Trd ldi cd 50
Tyle (%) 80,6
Thay doi sinh hoat ban than So PV 62
Trd ldi cd 61
Tyle (%) 983
Chung
si
PV 62
Trd ldi cd 61
Tyle (%)
98,7 Vdi cac gid tri so sdnh p(l:2;4)>0,05
Nhdn xet:
Ty le bfnh nhdn trd ldi c6 cdc dnh hudng cua benh Pemphigus din kinh ti vd ngudi thdn trong gia dinh, lam thay dii sinh hoat cua bdn than ngudi benh chung la 98,7%, trong do: Ty If benh nhan trd ldi mat nhiSu thdi gian, tin nhiiu tiin, ldm dnh hudng din ngudi than trong gia dinh, thay dii sinh ho^t cua bdn than rit cao, vdi cdc ty le mong ling 92,0%, 90,0%, 80,6% va 98,3%.
Cd su khdc biet ve ty le cac cdu hdi tia ldi anh hudng den ngudi than vdi cdc cau ttd ldi mdt nhiiu thdi gian, tin nhiiu tiin, thay dii sinh boat cua ban than, vdi cac ty If (80,6% so vdi 92,0%, 90,0% vd 98,3%, vdi p< 0,01).
4. KET LUAN
Cdc anh hudng cua benh Pemphigus den chit luong cupc sing ngudi benh rit rd rft. Cdc dnh hudng thudng gap Id: Dau (65,0%), nhuc va ngua (90,0%), anh hudng din cdc boat ddng mua sdm, chdm sdc nhd cOca (70,5%), dnh hudng tdi trang phuc cua ngudi benh; dnh budng rit nhiiu tdi sinh hoat vd thi due thi thao (79,0%), dnh hudng rdt nhiiu tdi cdng viec hpc tap, bi ngudi thdn vd gia dinh xa lanh, phdn bif t dii xu (79,0%), anh hudng cdc muc dp khdc nhau din ddi sing tinh due (100,0%).
Benh Pemphigus gdy mit nhieu thdi gian, tdn nhiiu tiin, dnh hudng din ngudi thdn Uong gia dinh, thay ddi smh ho?it cua ban thdn vdi cac ty If tuong ling 92,5%, 90,0%, 80,0% vd 98,7%.
14 S6l-2013 TAP CHiPH6NGCH6NGB|NHSgT RET VA CAC BiNHKY'SINH TRUNG
TAI LI$U THAM KHAO
1. Bp mdn Da liiu, Tnrdng D^ hpc Y khoa Hd Nf i (1992), Pemphigus, NXB Y hpc, Hd N§i 2. Nguyen Xudn Hiin, L6 Dinh An (1979), Pemphigus, Bdi gidng bfnh ngodi da vd hpa lieu
thdng thudng, Trudng Dai hpc Y Ha N$i, tjp 1, tr.l07 - 109.
3. Pham Anh Tuyit (1974), "Nhdn mOt trudng hpp bfnh Pemphigus tren phy nO cd thai", Thdng tin Da liiu, Si 4, tr,56 - 59.
4. Pham Diic Ngpc (1997), Nghiin cieu dich ti. ldm sdng vd cdn ldm sang binh Pemphigus thdng thuang tgi Vi$n Da liiu Trung umg vd Khoa Da liiu Vien Qudny 103, Lujn vdn tot ngbif p thac sy khoa hpc y - dupc, Hpc vif n Qudn y, Hd Tay.
5. Tran Lan Anh (2001), "Mpt vdi djc diim mien dich vd ca chi bfnh sinh bfnh Pemphigus", Npi san Da lieu, si 1, tr, 7 -12.
6. Anthony Teik-Jin Gooa, Suat-Hoon Tan (2001), "Coinparative Study of Pemphigus vulgaris and Pemphigus foliaceus in Singapore and Australian", Journal for Dermatology, Vol.42,pp. 172-175.
7. Ameman. J., Spun N.K., Buxton R.S. (1992), "The human gene (DSG3) Coding forthe Pemphigus vulgaris antigen is, Uke the genes coding for the other two known desmogleins, assigned to chromosome 18", Hum genet, 89347-50.
8. Amagai M (1995), "Adhesion molecules. 1. Keratinocyte - Keratinocyte interactions cadherins interactions cadherins and Pemphigus", J Invest Dermatol, Vol. 04, pp. 146-52.
9. Amagi M et al (1992), "Autoantibodies against the aminoterminal cadherin-like Binding domain of P. Vulgaris antigen are pathogenic", J. din Invest. Vol. 90; pp.919-26.
10. Henk Sillevis Smitt (2001), Pemphigus - Aetiology andpathogensis. Text Book pediauic of Dermatology, pp.731-732.
11. Lombardi M.L, Mereuto O, Rucco et al (1999), "Comon human leukocyte Antigen alleles alleles in Pemphigus Vulganis and P.F Italian patients", J.Invest Dermatol, Vol.113 (1), pp: 107-110.
12. Stephen I, Kazt (1984), "The epidermal basement membrane zone -structure Ontogeny and role in diseases", Joumal of American Academy of Dermatology, Vol, 11(6), 13. Skripkin Yu.K (1979), "Bullous Dermatoses", Mir Publishers, Moscow, pp.:375-384.
14. Tim Sothea (2001), Nghiin cUtu ddc diim ldm sdng vd kit qud dilu tri blnh blnh Pemphigus blnh Pemphigus bdng corticoide tgi Viln Dd liiu Trung uong tit 1995- 2000, Ludn van cao hpc, Dai hpc Y Ha Ndi,
15. Bastufi, Garin S, Souissi R, Blum L (1996), "Epidemiologic comparative du Pemphigus end Tunisie et en France", Arm - Dermatology - Venereal, Vol. 123, pp.337-342.
so 1-2013 TAP CHI PHONG C H 6 N G Bf NH S6T RET VA CAC BgNH KY SINH TRUNG 15
Abstract
A STUDY ON THE EFFECTS OF PEMPHIGUS ON PATIENTS' QUALITY OF LIFE IN 2012 IN THE CENTRAL HOSPITAL OF DERMATOLOGY
Cao Ba Loi', Can Xuan Luong^ Tran Lan Anh, Nguyen Thi Minh Hoa et al.
A cross - sectional study was conducted at National Hospital of Dermatology in 2012.
A total of 62 patients were interviewed in order to assess the effect of Pemphigus on patients' quality of life. This study showed that 65% of the patients had symptoms such as sticking, ache, itch. 90% supposed that Pemphigus had many effects on their daily life, shopping or housework for instances. 89% thought that Pemphigus affected patients' costume so much.
70,5% of the patients assumed that their life activities such as exercises and sports got much influenced. 79 % of the patients said it changed their work and study while 79% said they were kept away and discriminated against by their relatives and family. 100% of the patients revealed that it had bad impacts on their sex life with different levels: 33% got complex feeling, 41,5% were shy and 25,5% got reduced interest when having sexual activity.
Pemphigus treatment took time, cost a lot of money, and the disease had bad effects on family members, changed patients' daily activities with respective proportion of 92,5%, 90,0%, 80,0% and 98,7%.
Can bp phan bi^n:
PGS.TS. Nguyin Xudn Hiing Ngdy nhgn bdi: 09/01/2013 Ngdy gici phdn biin: 11/01/2013 Ngdy ddng bdi: 28/01/2013
' National Institute of Malariology.
^ Parasitology and Entomology.
