Afsar Baris, Ozdemir Nurhan Fatma, Sezer Siren, Haberal Mehmet
Department of Nephrology, Baskent University Hospital, Ankara, Turkey.
Hemodial Int. 2009 Jan;13(1):62-71. doi: 10.1111/j.1542-4758.2009.00329.x.
Hepatitis C virus (HCV) infection may deteriorate quality of life. The relationship between HCV infection and quality of life in hemodialysis (HD) patients is unknown. The demographic characteristics, comorbidities, biochemical parameters, and Malnutrition-Inflammation Score (MIS) were recorded. Child-Pugh classification, Beck Depression Inventory, and SF-36 were performed. Liver histopathology was examined. Thirty-two patients (21 Child-Pugh-A, 11 Child-Pugh-B) were included. There was high-grade portal necroinflammatory activity in 14, high-grade lobular necroinflammatory activity in 26, and hepatic fibrosis in 19 patients. Three patients had cirrhosis. Patients with a high stage of liver fibrosis had lower social functioning scores than patient with a low stage of fibrosis (P= 0.011). The only correlation was between aspartate aminotransferase and the physical function subscale (r=-0.395, P= 0.025). None of the SF-36 scores differed between Child-Pugh A and B patients. Instead, most of the SF-36 subscale and summary scores were related with hemoglobin, albumin, MIS and Beck Depression Score. Quality of life in HCV-infected HD patients was independent of liver disease severity anchors, but was correlated with anemia, malnutrition, and depression.
丙型肝炎病毒(HCV)感染可能会降低生活质量。HCV感染与血液透析(HD)患者生活质量之间的关系尚不清楚。记录了患者的人口统计学特征、合并症、生化参数以及营养不良-炎症评分(MIS)。进行了Child-Pugh分级、贝克抑郁量表和SF-36健康调查。检查了肝脏组织病理学。纳入了32例患者(21例Child-Pugh-A级,11例Child-Pugh-B级)。14例患者存在高级别门脉坏死性炎症活动,26例患者存在高级别小叶坏死性炎症活动,19例患者存在肝纤维化。3例患者有肝硬化。肝纤维化程度高的患者社会功能评分低于纤维化程度低的患者(P = 0.011)。唯一的相关性存在于天冬氨酸转氨酶与身体功能分量表之间(r = -0.395,P = 0.025)。Child-Pugh A级和B级患者的SF-36评分无差异。相反,大多数SF-36分量表和总分与血红蛋白、白蛋白、MIS和贝克抑郁评分相关。HCV感染的HD患者的生活质量与肝病严重程度指标无关,但与贫血、营养不良和抑郁相关。