Paterson D L, Gayowski T, Wannstedt C F, Wagener M M, Marino I R, Vargas H, Laskus T, Rakela J, Singh N
Veterans Affairs Medical Center and University of Pittsburgh, Thomas E. Starzl Transplantation Institute, PA 15240, USA.
Clin Transplant. 2000 Feb;14(1):48-54. doi: 10.1034/j.1399-0012.2000.140109.x.
Post liver transplant recurrence of infection with hepatitis C virus (HCV) occurs in approximately 50% of patients transplanted because of HCV-related liver disease. The aim of this study was to assess long-term quality of life, psychologic distress, and coping in patients with recurrent HCV after liver transplantation in comparison to patients transplanted for other etiologies of underlying liver disease. All liver transplant recipients transplanted at a University affiliated Veterans Affairs Medical Center who had greater than 6 months follow-up were sent a questionnaire investigating quality of life (assessed by Medical Outcomes study health survey SF-36), depression (assessed by Beck Depression Inventory), total mood disturbance (assessed by Profile of Mood States scale), coping (assessed by Billing and Moos Inventory of coping with illnesses), and employment status. Lower Beck Depression Inventory score (p = 0.001), lower mood disturbance score (p = 0.0001), overall satisfaction with present work (p = 0.0001), and lesser use of avoidant coping (p = 0.06) were predictors of better quality of life in long-term survivors of liver transplantation. At a mean follow-up of 4 yr after liver transplantation, patients with histopathologically diagnosed recurrent viral HCV hepatitis had significantly lower global quality of life score (mean score of 76.4 versus 86.2, p = 0.011) and physical functioning score (mean score 20 versus 25, p = 0.015), as compared to all other patients. In summary, quality of life and physical functioning were significantly impaired in liver transplant recipients with histopathologically diagnosed recurrent HCV hepatitis, as compared to those whose HCV hepatitis had not recurred or those transplanted for other reasons.
因丙型肝炎病毒（HCV）相关肝病接受肝移植的患者中，约50%会出现移植后HCV感染复发。本研究的目的是评估肝移植后HCV复发患者与因其他潜在肝病病因接受移植的患者相比的长期生活质量、心理困扰及应对方式。向一所大学附属退伍军人事务医疗中心所有接受肝移植且随访超过6个月的受者发送了一份调查问卷，调查生活质量（通过医学结局研究健康调查SF - 36评估）、抑郁（通过贝克抑郁量表评估）、总体情绪紊乱（通过情绪状态剖面图量表评估）、应对方式（通过比林和穆斯应对疾病量表评估）及就业状况。较低的贝克抑郁量表评分（p = 0.001）、较低的情绪紊乱评分（p = 0.0001）、对当前工作的总体满意度（p = 0.0001）以及较少使用回避应对方式（p = 0.06）是肝移植长期存活者生活质量较好的预测因素。在肝移植后平均4年的随访中，组织病理学诊断为复发性病毒性HCV肝炎的患者与所有其他患者相比，其总体生活质量评分显著更低（平均评分76.4对86.2，p = 0.011），身体功能评分也显著更低（平均评分20对25，p = 0.015）。总之，与HCV肝炎未复发的患者或因其他原因接受移植的患者相比，组织病理学诊断为复发性HCV肝炎的肝移植受者的生活质量和身体功能显著受损。
