Division of Pulmonary Medicine, University of Alberta Hospital, Edmonton, Alberta, Canada.
Can Respir J. 2009 Sep-Oct;16(5):153-8. doi: 10.1155/2009/843215.
BACKGROUND/OBJECTIVE: Traditional survival outcomes do not reflect the effects on the health-related quality of life (HRQL) of patients. HRQL following lung transplantation has not been studied systematically. The Health Utilities Index (HUI) is a family (HUI2 and HUI3) of measures of HRQL that has not been previously used to assess HRQL in lung transplantation. The objective of the present study was to assess the impact of lung transplantation on patient's HRQL using the HUI.
A total of 43 patients completed a battery of questionnaires before lung transplantation, and at three months and six months after lung transplantation. The 15-item questionnaire (HUI2 and HUI3) was used. Overall scores were based on a conventional scale (0.00 = dead, 1.00 = perfect health). Mental health was assessed by the Hospital Anxiety and Depression Scale. Adherence to medication and exercise were assessed by Morisky's and Godin's questionnaires, respectively.
Sixty-five per cent of the patients were men, with a mean age of 53 years (range 18 to 67 years). The mean overall HUI3 score for the lung transplant candidates (0.57) was much lower than for the lung transplant recipients (0.82) at six months post-transplantation. This difference was clinically important and statistically significant (P<0.05 [paired t test, degrees of freedom (df) = 35]). Differences in mean Hospital Anxiety and Depression Scale scores after transplantation were statistically significant (P<0.05 [paired t test, df=35]). After six months, transplant recipients were more adherent to medication (P<0.05 [X2 test, df=1]). Recipients were able to increase the duration of exercise at all levels of intensity.
Lung transplantation improved the patients' HRQL and adherence to medication. Anxiety levels persisted six months after transplantation but depression levels had decreased significantly.
背景/目的：传统的生存结果并不能反映患者健康相关生活质量（HRQL）的影响。肺移植后的 HRQL 尚未得到系统研究。健康效用指数（HUI）是一组 HRQL 衡量标准（HUI2 和 HUI3），以前并未用于评估肺移植患者的 HRQL。本研究的目的是使用 HUI 评估肺移植对患者 HRQL 的影响。
共有 43 名患者在肺移植前、肺移植后三个月和六个月完成了一系列问卷。使用 15 项问卷（HUI2 和 HUI3）。总体得分基于常规量表（0.00=死亡，1.00=完美健康）。心理健康通过医院焦虑和抑郁量表评估。药物和运动依从性分别通过 Morisky 和 Godin 的问卷评估。
65%的患者为男性，平均年龄为 53 岁（18 至 67 岁）。肺移植候选者的平均整体 HUI3 评分（0.57）远低于肺移植后六个月的受体（0.82）。这种差异在临床上很重要，且具有统计学意义（P<0.05[配对 t 检验，自由度(df)=35]）。移植后平均医院焦虑和抑郁量表评分的差异具有统计学意义（P<0.05[配对 t 检验，df=35]）。六个月后，移植受者对药物的依从性更高（P<0.05[X2 检验，df=1]）。受者能够在各个强度水平上增加运动时间。
肺移植改善了患者的 HRQL 和药物依从性。焦虑水平在移植后持续六个月，但抑郁水平显著下降。
