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目的研究中枢神经系统自身免疫性脱髓鞘病患者门诊随访依从性及其影响因素,为提出针对性措施提供依据。方法拟定调查问卷,采用电话问询的方式对中枢神经系统脱髓鞘疾病数据库中的患者进行问卷调查,将所研究的影响因素进行分析。结果单因素分析表明,男性、对疾病特点缺乏了解、初中及以下教育程度、非城镇医疗保险、外省居住和症状最重时扩展致残状态量表(EDSS)评分较低的患者门诊随诊依从性较差。多因素logistic回归分析结果显示,对疾病特点是否了解、是否外省居住和症状最重时EDSS评分具有统计学意义(P<0.05)。其中对疾病特点是否了解(OR=4.327,95%CI=2.200～8.511)和是否外省居住(OR=4.377,95%CI=1.133～16.907)是影响患者能否定期门诊随诊的独立危险因素;而症状最重时EDSS评分则为患者能否定期门诊随诊的保护因素(OR=0.845,95%CI=0.724～0.986),症状最重时EDSS评分越高的患者门诊随诊依从性更好。对目前治疗无信心是患者门诊随诊依从性差常见的主观原因。结论对疾病特点缺乏了解、症状最重时EDSS评分较低和居住在外省的患者门诊随诊依从性更差。
Objective To study outpatient follow-up compliance and its influencing factors in patients with central nervous system autoimmune demyelinating disease and to provide evidence for the targeted measures. Methods The questionnaire was drawn up and the questionnaires were collected by telephone inquiries from patients in the Demyelinating Disease Database of Central Nervous System. The influencing factors of the study were analyzed. Results Univariate analysis showed that males had poor understanding of the disease characteristics, and those with lower education level of junior high school and below, non-urban medical insurance, living in other provinces and those with the worst symptom of Extended Disability Status Scale (EDSS) Poor sex. Multivariate logistic regression analysis showed that whether the characteristics of the disease were well-known or not, whether EDESS was significantly different between residents living in other provinces and the most severe symptoms (P <0.05). Whether the disease characteristics were well-known (OR = 4.327, 95% CI = 2.200-8.511) and other provinces (OR = 4.377,95% CI = 1.133-16.907) were independent risk factors influencing patients’ The most severe symptoms of EDSS score for patients with regular out-patient protection factor (OR = 0.845, 95% CI = 0.724 ~ 0.986), the most severe symptoms of EDSS score higher patient outpatient follow-up is better . No confidence in the current treatment is the subjective cause of poor follow-up compliance in outpatient clinics. Conclusion The lack of understanding of the characteristics of the disease, the most severe symptoms when the lower EDSS score and living in other provinces out-patient clinic follow-up worse.