Evans R W
Health and Population Research Center, Battelle-Seattle Research Center, WA 98105.
Am J Kidney Dis. 1991 Oct;18(4 Suppl 1):62-70.
The clinical and quality of life outcomes of hemodialysis patients improve remarkably following treatment with recombinant human erythropoietin (Epo). However, few studies have compared the quality of life of Epo patients with that of end-stage renal disease (ESRD) patients on various treatment modalities. Data obtained in three separate studies of ESRD patients were comparatively analyzed. Over 1,500 patients from 23 dialysis and transplant centers were studied. Both objective and subjective quality of life were examined. Objective quality of life indicators included employment status, functional ability, and health status. Subjective quality of life indicators included well-being, life satisfaction, psychological affect, and happiness. Quality of life varied significantly across treatment modality, with transplant recipients generally reporting the highest levels of objective and subjective quality of life. However, hemodialysis patients treated with Epo reported a statistically significant improvement between baseline and 10 months' follow-up on all quality of life indicators, except employment. Epo patients reported a level of overall life satisfaction that exceeded that of patients on all ESRD treatment modalities. Among transplant recipients, diabetics reported the poorest quality of life, while patients on conventional immunosuppressive therapy often had a quality of life that exceeded that of patients on cyclosporine therapy. Some of these findings may be explained by case-mix differences, as well as differing study designs. Quality of life remains a significant concern among ESRD patients and the physicians and medical professionals responsible for their care. Unfortunately, the rehabilitation potential of many patients, despite the availability of Epo, and the success of transplantation, remains unmet.
重组人促红细胞生成素（Epo）治疗后，血液透析患者的临床和生活质量结果有显著改善。然而，很少有研究比较接受Epo治疗的患者与接受各种治疗方式的终末期肾病（ESRD）患者的生活质量。对在三项关于ESRD患者的独立研究中获得的数据进行了比较分析。研究了来自23个透析和移植中心的1500多名患者。对客观和主观生活质量都进行了检查。客观生活质量指标包括就业状况、功能能力和健康状况。主观生活质量指标包括幸福感、生活满意度、心理影响和快乐感。生活质量因治疗方式的不同而有显著差异，移植受者总体上报告的客观和主观生活质量水平最高。然而，接受Epo治疗的血液透析患者在基线和10个月随访期间，除就业外，所有生活质量指标均有统计学上的显著改善。接受Epo治疗的患者报告的总体生活满意度超过了所有ESRD治疗方式下的患者。在移植受者中，糖尿病患者的生活质量最差，而接受传统免疫抑制治疗的患者的生活质量往往超过接受环孢素治疗的患者。其中一些发现可能可以用病例组合差异以及不同的研究设计来解释。生活质量仍然是ESRD患者以及负责其护理的医生和医疗专业人员所关注的一个重要问题。不幸的是，尽管有Epo可用，许多患者的康复潜力以及移植的成功率仍未得到满足。
