Batki Steven L, Canfield Kelly M, Smyth Emily, Ploutz-Snyder Robert
University of California, San Francisco, Department of Psychiatry, and San Francisco VA Medical Center, 4150 Clement St. (116P), San Francisco, CA 94110, USA.
Drug Alcohol Depend. 2009 May 1;101(3):176-82. doi: 10.1016/j.drugalcdep.2008.12.012. Epub 2009 Feb 23.
To assess health-related quality of life (HRQOL) in methadone maintenance treatment (MMT) patients with untreated chronic HCV infection and to determine the clinical factors that predict HRQOL.
HRQOL was measured in 100 MMT patients entering an HCV treatment trial. Subjects were mostly male (61%) and white (81%) with a mean age of 43 (+/-10). 57% had a current non-substance use psychiatric disorder. 55% had a current (past 12 months) substance use disorder, including 44% with current opioid or cocaine abuse/dependence. HRQOL in our sample was compared to published reports for the general population as well as for non-MMT HCV patients. To assess predictors of SF-36 HRQOL, hierarchical multiple regression techniques were used to assess model improvement with four blocks of baseline predictors: Demographics, Medical Severity, Addiction Severity, and Depression Severity.
HRQOL scores were significantly lower than scores for the general population and were also lower than scores reported for untreated HCV patients not in MMT. Regression analysis demonstrated a consistent pattern whereby Depression Severity increased predictive accuracy for HRQOL measures over simpler models. Beck Depression Inventory scores significantly predicted quality of life across both the mental and physical composite scores and all eight sub-scales of the SF-36.
Untreated HCV patients in MMT had lower HRQOL than HCV patients not in MMT. Depression Severity was associated with significantly lower quality of life measures, suggesting that psychiatric evaluation and intervention prior to the start of HCV treatment may improve overall quality of life and could influence HCV treatment outcomes in MMT patients.
评估接受美沙酮维持治疗（MMT）且未治疗的慢性丙型肝炎病毒（HCV）感染患者的健康相关生活质量（HRQOL），并确定预测HRQOL的临床因素。
对100名进入HCV治疗试验的MMT患者进行HRQOL测量。受试者大多为男性（61%），白人（81%），平均年龄43岁（±10岁）。57%的患者目前患有非物质使用性精神障碍。55%的患者目前（过去12个月内）患有物质使用障碍，其中44%的患者目前存在阿片类药物或可卡因滥用/依赖。将我们样本中的HRQOL与已发表的普通人群以及非MMT HCV患者的报告进行比较。为了评估SF - 36 HRQOL的预测因素，采用分层多元回归技术，通过四个基线预测因素块来评估模型改进：人口统计学、医疗严重程度、成瘾严重程度和抑郁严重程度。
HRQOL得分显著低于普通人群得分，也低于未接受MMT的未治疗HCV患者报告的得分。回归分析显示了一种一致的模式，即与更简单的模型相比，抑郁严重程度提高了HRQOL测量的预测准确性。贝克抑郁量表得分显著预测了精神和身体综合得分以及SF - 36所有八个子量表的生活质量。
接受MMT的未治疗HCV患者的HRQOL低于未接受MMT的HCV患者。抑郁严重程度与显著更低的生活质量测量值相关，这表明在开始HCV治疗之前进行精神评估和干预可能会改善整体生活质量，并可能影响MMT患者的HCV治疗结果。
