Background and aims: Patients with ulcerative colitis have reduced health-related quality of life compared to the general population. Current treatment strategy aims to reduce patients’ symptoms and increase health-related quality of life. We investigated which symptoms of ulcerative colitis correlate to decreased health-related quality of life.

Methods: Among 743 patients with moderate to severely active ulcerative colitis receiving biological therapy in a cross-sectional national study, we determined which disease-related symptoms, as measured by the Simple Clinical Colitis Activity Index, worsened health-related quality of life scores across the Short Health Scale dimensions, while adjusting for treatment, age, and clinical manifestation, and stratifying for sex, by means of multiple linear regression.

Results: Patients with active disease had decreased health-related quality of life compared to those with inactive disease (median 5.8 (range 4.5–7.5) vs. 2 (0.8–3.3)). Both sexes had decreased health-related quality of life in all dimensions for the symptoms: bowel frequency during daytime (0.37–0.86 and 0.46–0.84), urgency of defecation (0.54–0.79 and 0.49–0.65) and blood in stool (0.50–0.75 and 0.36–0.54) for men and women respectively. Women were more often negatively affected by bowel frequency during night-time (4 domains vs. 1) and arthritis (5 domains vs. 3). In non-stratified analysis female sex is an independent predictor of lower health-related quality of life for 3 domains (0.38–0.53).

Conclusions: Health-related quality of life was most prominently associated with bowel frequency during daytime, urgency of defecation, and blood in stool. Other symptoms associated for some health-related quality of life dimensions, and appear to vary between the sexes.

背景与目的：溃疡性结肠炎患者的健康相关生活质量较普通人群有所下降。当前的治疗策略旨在减轻患者的症状并提高健康相关的生活质量。我们调查了溃疡性结肠炎的哪些症状与健康相关的生活质量下降有关。

方法：在一项横断面的全国性研究中，在743例中度至重度溃疡性结肠炎患者中接受生物疗法的治疗中，我们确定了通过简单临床结肠炎活动指数衡量的哪些疾病相关症状使健康相关生活质量评分恶化短期健康量表的维度，同时通过多元线性回归调整治疗，年龄和临床表现，并对性别进行分层。

结果：与非活动性疾病相比，活动性疾病患者的健康相关生活质量下降（中位数5.8（范围4.5-7.5）对2（0.8-3.3））。男女各方面的症状都与健康相关的生活质量下降：白天排便频率（0.37–0.86和0.46–0.84），排便紧迫（0.54-0.79和0.49–0.65）和粪便中的血液（0.50–分别为0.75和0.36-0.54）。妇女在夜间（4个区域对1个区域）和关节炎（5个区域对3个区域）的肠道排便次数经常受到负面影响。在非分层分析中，女性是3个域（0.38–0.53）下与健康相关的较低生活质量的独立预测因子。

结论：与健康相关的生活质量与白天排便次数，排便的紧迫性和粪便中的血液最为相关。与某些健康相关的生活质量维度相关的其他症状，似乎在男女之间有所不同。