Tomioka Hiromi, Imanaka Kazufumi, Hashimoto Kimio, Iwasaki Hironobu
Department of Respiratory Medicine, Nishi-Kobe Medical Center, Kobe.
Intern Med. 2007;46(18):1533-42. doi: 10.2169/internalmedicine.46.6218. Epub 2007 Sep 14.
To validate the cross-sectional and longitudinal use of the Medical Outcome Study Short Form 36 (SF-36) for measuring health-related quality of life (HRQL) in patients with idiopathic pulmonary fibrosis (IPF).
Patients were administered the SF-36 and concomitantly underwent laboratory and physiologic tests and high-resolution computed tomography (HRCT). Forty-six patients participated in the initial cross-sectional study, and 32 patients who were available more than one year later again underwent these studies under the same conditions.
Patients with IPF had significantly lower scores across all 8 domains of the SF-36 when compared with the general population. Significant decline of HRQL was observed in 2 physical domains. There were significant differences in within-subject changes in a few domains according to worsening of the physiologic parameters. Vital capacity as percent of predicted was significantly correlated with the results of 6 subscales and its changes were significantly correlated with those of 4 subscales. The 6-min-walk distance was correlated significantly with 3 subscales and its changes were significantly correlated with those of 4 subscales. Changes in the HRCT ground-glass score were significantly correlated with those of 3 subscales. No significant correlations between changes in 3 domains and those of any clinical parameters were observed.
Patients with IPF had significantly impaired HRQL in both physical and psychological functions. This disease clearly decreased the physical aspects of HRQL over time. HRQL instruments should be incorporated into routine evaluations of IPF patients, since they measure dimensions not fully estimated by clinical assessment.
验证医学结局研究简明健康调查问卷36项版本(SF - 36)在测量特发性肺纤维化(IPF)患者健康相关生活质量(HRQL)方面的横断面和纵向应用。
对患者进行SF - 36问卷调查,并同时进行实验室检查、生理测试和高分辨率计算机断层扫描(HRCT)。46例患者参与了初始横断面研究,32例在一年多后仍可进行研究的患者在相同条件下再次接受这些检查。
与普通人群相比,IPF患者在SF - 36的所有8个领域得分均显著较低。在2个身体领域观察到HRQL显著下降。根据生理参数的恶化情况,在几个领域的受试者内变化存在显著差异。预测肺活量百分比与6个分量表的结果显著相关,其变化与4个分量表的变化显著相关。6分钟步行距离与3个分量表显著相关,其变化与4个分量表的变化显著相关。HRCT磨玻璃影评分的变化与3个分量表的变化显著相关。未观察到3个领域的变化与任何临床参数的变化之间存在显著相关性。
IPF患者在身体和心理功能方面的HRQL均显著受损。随着时间的推移,这种疾病明显降低了HRQL的身体方面。HRQL评估工具应纳入IPF患者的常规评估中,因为它们能够测量临床评估未完全评估的维度。