Servei de Medicina Interna-Hepatologia, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
Eur J Gastroenterol Hepatol. 2010 Feb;22(2):221-7. doi: 10.1097/MEG.0b013e3283319975.
Improvement of prognosis and availability of diverse therapeutic options for complications of advanced liver disease highlight the importance of health-related quality of life (HRQOL) in cirrhosis. The aim of this study was to identify factors that influence HRQOL and may be potentially treatable in patients with cirrhosis.
HRQOL was measured in 212 outpatients with cirrhosis using a generic questionnaire (Medical Outcomes Study Form, SF-36) and a liver-specific questionnaire (Chronic Liver Disease Questionnaire, CLDQ). All patients underwent a systematic clinical and neuropsychological assessment. Independent factors associated with poor HRQOL were identified by multiple linear regression.
HRQOL scores exhibited by patients were: global CLDQ: 4.8+/-1.2; Physical Component Score of SF-36: 38.5+/-10.7; Mental Component Score of SF-36: 45.3+/-14.3. The independent variables for global CLDQ were female sex, nonalcoholic etiology, current ascites, and a decrease in albumin (R = 0.22). For Physical Component Score of SF-36, the independent variables were prior hepatic encephalopathy, current ascites, and a decrease in hemoglobin (R = 0.22). For Mental Component Score of SF-36, the independent variables were nonalcoholic etiology, the Grooved Pegboard test, and a decrease in hemoglobin (R = 0.14).
Several clinical variables, potentially treatable, may alter particular aspects of HRQOL. Correction of ascites, hypoalbuminemia, minimal hepatic encephalopathy, and anemia may cause a positive impact on HRQOL of patients with cirrhosis.
提高晚期肝病并发症的预后和多种治疗选择的可及性,凸显了肝硬化患者健康相关生活质量(HRQOL)的重要性。本研究旨在确定影响 HRQOL 的因素,并确定可能对肝硬化患者进行潜在治疗的因素。
使用通用问卷(医疗结果研究形式,SF-36)和特定于肝脏的问卷(慢性肝病问卷,CLDQ)对 212 名肝硬化门诊患者进行 HRQOL 测量。所有患者均接受了系统的临床和神经心理学评估。通过多元线性回归确定与 HRQOL 差相关的独立因素。
患者的 HRQOL 评分如下:全球 CLDQ:4.8+/-1.2;SF-36 生理成分评分:38.5+/-10.7;SF-36 心理成分评分:45.3+/-14.3。全球 CLDQ 的独立变量为女性、非酒精性病因、当前腹水和白蛋白减少(R = 0.22)。SF-36 生理成分评分的独立变量为既往肝性脑病、当前腹水和血红蛋白减少(R = 0.22)。SF-36 心理成分评分的独立变量为非酒精性病因、滚柱式 peg 板测试和血红蛋白减少(R = 0.14)。
一些潜在可治疗的临床变量可能会改变 HRQOL 的特定方面。纠正腹水、低白蛋白血症、轻微肝性脑病和贫血可能会对肝硬化患者的 HRQOL 产生积极影响。