Künsebeck Hans W, Kugler Christiane, Fischer Stefan, Simon Andre R, Gottlieb Jens, Welte Tobias, Haverich Axel, Strueber Martin
Hannover Medical School, Hannover, Germany.
Prog Transplant. 2007 Jun;17(2):136-41. doi: 10.1177/152692480701700209.
Lung transplantation has become an established and effective treatment for patients with end-stage pulmonary disease.
To investigate health-related quality of life in correlation with occurrence and degree of bronchiolitis obliterans syndrome after transplantation.
In a cross-sectional study design, 119 consecutive lung transplant recipients (63.9% bilateral and 36.1% single lung transplants) responded voluntarily to a set of standardized questionnaires (12-Item Short-Form Health Survey, Center for Epidemiologic Studies-Depression Scale, Coping With Everyday Life, Beck Anxiety Inventory, Zerssen list of complaints) that covered health-related quality of life and psychological well being. Also, we performed pulmonary function studies to clinically grade bronchiolitis obliterans syndrome in all patients.
In this cohort, 41.2% of patients developed bronchiolitis obliterans syndrome at a mean interval of 5.6 years after lung transplantation. Actuarial freedom from bronchiolitis obliterans syndrome was 90.1% +/- 2.3% at 1 year, 79.9% +/- 3.7% at 3 years, and 59.5% +/- 4.8% at 5 years after lung transplantation. Recipients with bronchiolitis obliterans syndrome reported significantly lower well being and quality of life than those without bronchiolitis obliterans syndrome, who scored similar to healthy volunteers. In a subanalysis, body functioning (P < .001) and related areas of coping (P < .001) were mostly affected by bronchiolitis obliterans syndrome.
Quality of life was negatively affected by the onset of bronchiolitis obliterans syndrome. However, even patients who develop bronchiolitis obliterans syndrome reported a temporary benefit from lung transplantation. In addition to optimal medical care and efforts in preventing bronchiolitis obliterans syndrome, psychological support of lung recipients seems to be essential, especially when bronchiolitis obliterans syndrome occurs.
肺移植已成为终末期肺病患者一种既定且有效的治疗方法。
研究与移植后闭塞性细支气管炎综合征的发生及程度相关的健康相关生活质量。
在一项横断面研究设计中，119名连续的肺移植受者（63.9%为双侧肺移植，36.1%为单肺移植）自愿回答了一组标准化问卷（12项简短健康调查问卷、流行病学研究中心抑郁量表、应对日常生活问卷、贝克焦虑量表、泽尔森症状清单），这些问卷涵盖了健康相关生活质量和心理健康状况。此外，我们对所有患者进行了肺功能研究，以对闭塞性细支气管炎综合征进行临床分级。
在该队列中，41.2%的患者在肺移植后平均5.6年出现闭塞性细支气管炎综合征。肺移植后1年无闭塞性细支气管炎综合征的精算生存率为90.1%±2.3%，3年为79.9%±3.7%，5年为59.5%±4.8%。患有闭塞性细支气管炎综合征的受者报告的幸福感和生活质量明显低于未患闭塞性细支气管炎综合征的受者，后者的得分与健康志愿者相似。在亚组分析中，身体功能（P<0.001）和相关应对领域（P<0.001）受闭塞性细支气管炎综合征影响最大。
闭塞性细支气管炎综合征的发生对生活质量有负面影响。然而，即使是发生闭塞性细支气管炎综合征的患者也报告称肺移植带来了暂时的益处。除了最佳的医疗护理和预防闭塞性细支气管炎综合征的努力外，肺移植受者的心理支持似乎至关重要，尤其是在发生闭塞性细支气管炎综合征时。
