Chua R, Keogh A M, Byth K, O'Loughlin A
Department of Cardiology, St Vincent's Hospital, Sydney, Australia.
Intern Med J. 2006 Nov;36(11):705-10. doi: 10.1111/j.1445-5994.2006.01169.x.
Pulmonary hypertension, when advanced, markedly limits exercise capacity, activities of daily living and quality of life (QoL). No measure of QoL has yet been validated for the assessment of pulmonary hypertension. The aim of the study was to compare the validity of the Minnesota Living with Heart Failure (MLwHF) questionnaire, the Short Form-36 (SF-36) questionnaire and the Australian Quality of Life (AQoL) measure for assessing pulmonary hypertension treatment.
Eighty-three patients were enrolled in three studies of pulmonary hypertension treatment (treprostinil, bosentan and sildenafil). They were assessed at baseline and 3 months with the MLwHF questionnaire. Treprostinil and bosentan groups also had 6 and 12 months' data. Twenty-one patients in the sildenafil trial completed concurrently, the SF-36 and AQoL measures at baseline and 3 months. QoL scores were correlated with the 6-min walk test distance, New York Heart Association functional class and right heart catheter-derived haemodynamic parameters of the disease for all matching time points and for changes in scores and clinical measurements over time.
The MLwHF and SF-36 scores correlated well with the 6-min walk test distance and New York Heart Association functional class, but did not correlate with haemodynamic measurements. MLwHF and SF-36 scores also correlated with the rate of change of the 6-min walk test distance and New York Heart Association functional class over time.
The MLwHF questionnaire and SF-36 are useful tools for the assessment of QoL in pulmonary hypertension and may be useful in the ongoing evaluation of QoL in the treatment and study of pulmonary hypertension.
肺动脉高压进展到晚期时,会显著限制运动能力、日常生活活动及生活质量(QoL)。目前尚无用于评估肺动脉高压的生活质量测量方法得到验证。本研究的目的是比较明尼苏达心力衰竭生活问卷(MLwHF)、简短健康调查问卷(SF-36)和澳大利亚生活质量量表(AQoL)在评估肺动脉高压治疗方面的有效性。
83名患者参与了三项肺动脉高压治疗研究(曲前列尼尔、波生坦和西地那非)。在基线期和3个月时,使用MLwHF问卷对他们进行评估。曲前列尼尔组和波生坦组还拥有6个月和12个月的数据。西地那非试验中的21名患者在基线期和3个月时同时完成了SF-36和AQoL测量。在所有匹配的时间点,以及随时间推移的评分和临床测量变化方面,生活质量评分与6分钟步行试验距离、纽约心脏协会功能分级以及疾病的右心导管血流动力学参数相关。
MLwHF和SF-36评分与6分钟步行试验距离和纽约心脏协会功能分级相关性良好,但与血流动力学测量无关。MLwHF和SF-36评分也与6分钟步行试验距离和纽约心脏协会功能分级随时间的变化率相关。
MLwHF问卷和SF-36是评估肺动脉高压患者生活质量的有用工具,可能有助于在肺动脉高压治疗和研究中持续评估生活质量。