Estraviz Begoña, Quintana José M, Valdivieso Andrés, Bilbao Amaia, Padierna Angel, de Urbina Jorge Ortiz, Sarabia Sebastian
Servicio Cirugía Gral y Aparato Digestivo, Hospital de Galdakao, Galdakao, Vizcaya, Spain.
Clin Transplant. 2007 Jul-Aug;21(4):481-99. doi: 10.1111/j.1399-0012.2007.00672.x.
To assess health-related quality of life (HRQoL) in patients following liver transplantation and the factors associated with HRQoL variation.
Sociodemographic and clinical data were collected for 60 consecutive patients activated for liver transplantation in a single hospital. Patients were classified according to the severity of the cirrhosis (Child-Pugh class) and disease etiology (alcoholic cirrhosis, viral cirrhosis, cholestatic diseases, and hepatocarcinoma). HRQoL was assessed by three different questionnaires: the Health Survey Short Form 36 (SF-36), the Hospital Anxiety and Depression Scale (HAD), and a specific-symptom questionnaire. Questionnaires were completed during the pre-operative period and six months after transplantation.
In the pre-operative period, patients with Child A had higher mean levels of HRQoL than did those in other groups. At six months following transplantation, there were no significant differences among the groups, largely because gains obtained by patients with Child B and C were much greater than those attained by patients with Child A. Across the four etiological groups, there were significant differences in all domains of the three questionnaires, except SF-36-bodily pain and HAD-anxiety, prior to transplantation, because patients with hepatocarcinoma had much better HRQoL. After transplantation, there were no differences because patients with viral and alcohol-induced cirrhosis achieved greater gains with respect to the neoplastic group. During the pre-operative period, the scores for all areas of the SF-36 and for all groups were below the general population normalized score of 50 (except for patients with Child class A and those affected with hepatocarcinoma). Six-months post-transplantation, the scores on most of the domains remained below 50, except for certain mental areas in which higher scores were attained.
Health-related quality of life is influenced by the severity and etiology of cirrhosis-patients with Child class C and those with alcoholic or viral cirrhosis have the poorest quality of life. There were no differences observed among the groups after the transplantation, as the patients with the lowest HRQoLs prior to surgery demonstrated greater gains in HRQoL associated with liver transplantation.
评估肝移植患者的健康相关生活质量（HRQoL）以及与HRQoL变化相关的因素。
收集了一家医院连续60例准备进行肝移植患者的社会人口统计学和临床数据。患者根据肝硬化的严重程度（Child-Pugh分级）和疾病病因（酒精性肝硬化、病毒性肝硬化、胆汁淤积性疾病和肝癌）进行分类。HRQoL通过三种不同的问卷进行评估：健康调查简表36（SF-36）、医院焦虑抑郁量表（HAD）和一份特定症状问卷。问卷在术前和移植后六个月完成。
在术前，Child A级患者的HRQoL平均水平高于其他组。移植后六个月，各组之间无显著差异，这主要是因为Child B级和C级患者获得的改善远大于Child A级患者。在四个病因组中，术前三种问卷的所有领域均存在显著差异，但SF-36身体疼痛和HAD焦虑除外，因为肝癌患者的HRQoL要好得多。移植后，没有差异，因为病毒性和酒精性肝硬化患者相对于肿瘤组获得了更大的改善。在术前，SF-36所有领域的得分以及所有组的得分均低于一般人群的标准化得分50（Child A级患者和肝癌患者除外）。移植后六个月，大多数领域的得分仍低于50，但某些心理领域得分较高。
健康相关生活质量受肝硬化严重程度和病因的影响——Child C级患者以及酒精性或病毒性肝硬化患者的生活质量最差。移植后各组之间未观察到差异，因为术前HRQoL最低的患者在肝移植后HRQoL有更大改善。
