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丙型肝炎患者在不同肝病阶段的生活质量和认知功能

Quality of life and cognitive function in hepatitis C at different stages of liver disease.

作者信息

Córdoba Juan, Flavià Montse, Jacas Carlos, Sauleda Silvia, Esteban Juan Ignacio, Vargas Víctor, Esteban Rafael, Guardia Jaume

机构信息

Servei de Medicina Interna-Hepatologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119, Barcelona 08035, Spain.

出版信息

J Hepatol. 2003 Aug;39(2):231-8. doi: 10.1016/s0168-8278(03)00189-2.

Abstract

BACKGROUND/AIMS: Hepatitis C has been associated with a decrease in quality of life and with neurological abnormalities. The aim of our study was to investigate the relationship between quality of life and cognitive function.

METHODS

Quality of life, clinical variables and neuropsychological function were evaluated in 120 patients with hepatitis C (mild chronic hepatitis, compensated cirrhosis and decompensated cirrhosis) and in healthy controls (n=40, in each group).

RESULTS

Patients with chronic hepatitis or compensated cirrhosis showed a decrease in quality of life, in spite of unimpaired neuropsychological tests. Patients with decompensated cirrhosis exhibited a further decrease in quality of life and neuropsychological abnormalities. The decrease in quality of life was associated with the severity of liver failure, neuropsychological abnormalities and treatment with beta-blockers or diuretics. However, in the multivariable analysis, only treatment with beta-blockers or diuretics (which was limited to decompensated cirrhosis) was independently associated with quality of life.

CONCLUSIONS

Hepatitis C causes a decrease in quality of life even in the absence of major cognitive impairment. The mechanisms that worsen quality of life are unknown. However, in cirrhotic outpatients with prior decompensations, treatment with beta-blockers or diuretics appears to have an important effect on quality of life.

摘要

背景/目的:丙型肝炎与生活质量下降及神经功能异常有关。本研究旨在探讨生活质量与认知功能之间的关系。

方法

对120例丙型肝炎患者(轻度慢性肝炎、代偿期肝硬化和失代偿期肝硬化)及健康对照者(每组n = 40)进行生活质量、临床变量及神经心理功能评估。

结果

尽管神经心理测试未受损,但慢性肝炎或代偿期肝硬化患者的生活质量仍有所下降。失代偿期肝硬化患者的生活质量进一步下降且存在神经心理异常。生活质量下降与肝衰竭的严重程度、神经心理异常以及使用β受体阻滞剂或利尿剂治疗有关。然而,在多变量分析中,仅使用β受体阻滞剂或利尿剂治疗(仅限于失代偿期肝硬化)与生活质量独立相关。

结论

即使在没有严重认知障碍的情况下,丙型肝炎也会导致生活质量下降。生活质量恶化的机制尚不清楚。然而,在既往有失代偿情况的肝硬化门诊患者中,使用β受体阻滞剂或利尿剂治疗似乎对生活质量有重要影响。

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