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[慢性病毒性肝病患者生活质量及其相关因素评估]

[Assessment of quality of life and associated factors in patients with chronic viral liver disease].

作者信息

Park Chang Keun, Park Soo Young, Kim Eun Soo, Park Jin Hyung, Hyun Dong Woo, Yun Young Mi, Jo Chang Min, Tak Won Young, Kweon Young Oh, Kim Sung Kook, Choi Yong Hwan, Park Shin Goo

机构信息

Kyungpook National University College of Medicine, Daegu, Korea.

出版信息

Taehan Kan Hakhoe Chi. 2003 Sep;9(3):212-21.

Abstract

BACKGROUND/AIMS: The aim of this study was to measure health related quality of life (HRQOL) in patients with chronic viral hepatitis or cirrhosis and to determine factors associated with more severe impairment.

METHODS

We conducted a cross-sectional study in which we documented patients' demographic and clinical characteristics and measured their HRQOL using the Korean version of Short Form-36. A total of 375 patients were enrolled in the study. We compared patients' HRQOL with that of 750 participants in a control group and assessed the association of HRQOL impairment with clinical parameters.

RESULTS

In all except two domains (physical functioning, bodily pain) of SF-36, HRQOL scores were significantly lower in the patient group than in the control group (p<0.001). The difference was more prominent in those domains reflective of mental, rather than physical, health. When patient group was classified as noncirrhosis, Child A, B, or C according to modified Child-Pugh classification, severe liver disease was associated with a lower HRQOL score. Interestingly, scores of domains reflective of mental health were decreased from the early stage of disease (noncirrhosis or Child-Pugh A). Those of domains reflective of physical health, however, were decreased only in advanced stages of disease (Child-Pugh B or C). There are weak but significant correlations between SF-36 scores and age, serum albumin, serum bilirubin, and prothrombin time, but no correlation with histologic activity, transaminase level, disease duration, virus type (HBV or HCV) and HBV DNA level.

CONCLUSIONS

Compared with the control group, patients with chronic viral hepatitis or cirrhosis showed substantial impairment of HRQOL, which is further affected by worsening disease severity. More concern about HRQOL should be warranted in the evaluation of health change due to disease progression or therapeutic trial.

摘要

背景/目的:本研究旨在测量慢性病毒性肝炎或肝硬化患者的健康相关生活质量(HRQOL),并确定与更严重损害相关的因素。

方法

我们进行了一项横断面研究,记录患者的人口统计学和临床特征,并使用韩国版简明健康调查问卷(Short Form-36,SF-36)测量他们的HRQOL。共有375名患者纳入本研究。我们将患者的HRQOL与750名对照组参与者的HRQOL进行比较,并评估HRQOL损害与临床参数之间的关联。

结果

除SF-36的两个领域(身体功能、身体疼痛)外,患者组的HRQOL得分在所有领域均显著低于对照组(p<0.001)。这种差异在反映心理健康而非身体健康的领域更为突出。根据改良Child-Pugh分类将患者组分为非肝硬化、Child A、B或C时,严重肝病与较低的HRQOL得分相关。有趣的是,反映心理健康的领域得分从疾病早期(非肝硬化或Child-Pugh A)就开始下降。然而,反映身体健康的领域得分仅在疾病晚期(Child-Pugh B或C)下降。SF-36得分与年龄、血清白蛋白、血清胆红素和凝血酶原时间之间存在微弱但显著的相关性,但与组织学活动、转氨酶水平、病程、病毒类型(HBV或HCV)和HBV DNA水平无关。

结论

与对照组相比,慢性病毒性肝炎或肝硬化患者的HRQOL有显著损害,疾病严重程度的恶化会进一步影响HRQOL。在评估疾病进展或治疗试验引起的健康变化时,应更加关注HRQOL。

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