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先天性心脏病成人的生活质量

Quality of life in adults with congenital heart disease.

作者信息

Lane D A, Lip G Y H, Millane T A

机构信息

University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.

出版信息

Heart. 2002 Jul;88(1):71-5. doi: 10.1136/heart.88.1.71.

Abstract

OBJECTIVE

To examine the quality of life of adults with congenital heart disease.

DESIGN AND SETTING

Observational, cross sectional study conducted at one general hospital in Birmingham, UK.

PATIENTS

All 471 patients registered at the adult congenital heart disease clinic were sent the 36 item short form health survey (SF-36) to assess their quality of life. Questionnaires were completed by 276 (58.6%) patients (41.7% men; median (interquartile range) age 31.0 (26.3-36.0) years, range 16-85 years).

RESULTS

Surprisingly, patients deemed surgically cured (for example, atrial septal defect repair) had significantly poorer quality of life in all domains (all p < 0.05), except for pain, than the general population, as determined from population normative data. Patients who had received palliative treatment reported quality of life scores similar to those who had never required cardiac surgery and to the general population, although both patient groups had significantly poorer physical functioning and overall general health perception than the general population (all p < 0.01). Patients with inoperable conditions had significantly poorer physical functioning (all p < 0.01) and overall general health perception (all p < 0.05) than all other patients, and significantly worse quality of life in all domains than the similarly aged general population. Patients with cyanotic conditions had significantly worse quality of life than age and sex matched acyanotic patients (all p < 0.01).

CONCLUSIONS

Patients with inoperable or cyanotic conditions and, paradoxically, those deemed surgically cured, had the poorest quality of life among adults with congenital heart disease. However, all adults with congenital heart disease had significantly poorer levels of physical functioning and overall general health perception then similarly aged people in the general population.

摘要

目的

研究成年先天性心脏病患者的生活质量。

设计与地点

在英国伯明翰一家综合医院开展的观察性横断面研究。

患者

向成年先天性心脏病诊所登记的所有471例患者发放36项简短健康调查问卷(SF - 36),以评估其生活质量。276例(58.6%)患者完成了问卷调查(男性占41.7%;年龄中位数(四分位间距)为31.0(26.3 - 36.0)岁,年龄范围为16 - 85岁)。

结果

令人惊讶的是,根据人群标准数据确定,那些被认为手术治愈的患者(如房间隔缺损修补术),除疼痛外,在所有领域的生活质量均显著低于普通人群(所有p < 0.05)。接受姑息治疗的患者报告的生活质量得分与从未接受心脏手术的患者以及普通人群相似,尽管这两组患者的身体功能和总体健康感知均显著低于普通人群(所有p < 0.01)。无法手术治疗的患者身体功能(所有p < 0.01)和总体健康感知(所有p < 0.05)均显著低于所有其他患者,并且在所有领域的生活质量均显著低于年龄相仿的普通人群。患有青紫型心脏病的患者生活质量显著低于年龄和性别匹配的非青紫型患者(所有p < 0.01)。

结论

在成年先天性心脏病患者中,无法手术治疗或患有青紫型心脏病的患者,以及自相矛盾的是那些被认为手术治愈的患者,生活质量最差。然而,所有成年先天性心脏病患者的身体功能水平和总体健康感知均显著低于年龄相仿的普通人群。

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