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肢端肥大症患者生活质量的短期和长期变化:一项前瞻性研究的结果。

Short- and long-term changes of quality of life in patients with acromegaly: results from a prospective study.

机构信息

Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy.

出版信息

J Endocrinol Invest. 2010 Jan;33(1):20-5. doi: 10.1007/BF03346555.

Abstract

Quality of life (QoL) may be affected in acromegalic patients, although the role of disease activity is still unsettled. The aim of the study was to assess the QoL of acromegalic patients with a specific questionnaire (ACROQOL). ACROQOL was evaluated in a prospective study (at baseline, at 6 and 24 months) in 23 active untreated acromegalic patients. Control of acromegaly was defined by normal age-matched serum IGF-I concentrations. Patient groups were defined as controlled or uncontrolled at 6 months and at 24 months: controlled or uncontrolled during the entire study period (ACRO(CC) or ACRO(NC), respectively) or uncontrolled at 6 months and controlled thereafter (ACRO(C)). At 6 months, ACROQOL scores improved globally (from 54.3+/-21 to 65.1+/-19, p=0.04) as did subdomains and were inversely related to IGF-I variation (r=-0.50, p=0.052). At 24 months, ACROQOL improved globally (from 54.3+/-21 to 65.7+/-18.0, p=0.04) and this was also seen in the appearance subdomains; however, no correlation was revealed between variation of serum IGF-I concentrations and changes in ACROQOL total score (r=0.008, p=0.87). ACROQOL scores did not significantly change in ACRO(NC) (p=0.310) and in ACRO(C) (p=0.583), whereas it improved globally (from 42.1+/-22.1 to 58.8+/-16.04, p=0.021) and in psychological subdomains in ACRO(CC); however, it reflected the improvement occurred within the first 6 months of disease control. In conclusion, successful treatment, which normalizes disease activity, improves QoL in acromegaly in the short term. However, the lack of correlation between the ACROQOL score in the long term might suggest that factors other than serum IGF-I participate in the well-being of acromegalic patients; however, due to the small sample size, our results need to be confirmed in larger studies.

摘要

生活质量(QoL)可能会受到肢端肥大症患者的影响,尽管疾病活动的作用仍未确定。本研究的目的是使用特定问卷(ACROQOL)评估肢端肥大症患者的生活质量。ACROQOL 在一项前瞻性研究中进行了评估(基线时、6 个月和 24 个月时),共纳入 23 例未经治疗的活动期肢端肥大症患者。通过正常年龄匹配的血清 IGF-I 浓度来定义肢端肥大症的控制情况。患者组在 6 个月和 24 个月时被定义为控制或未控制:6 个月和 24 个月时整个研究期间均控制(ACRO(CC)或 ACRO(NC))或 6 个月时未控制但此后控制(ACRO(C))。6 个月时,ACROQOL 评分整体(从 54.3+/-21 提高至 65.1+/-19,p=0.04)和各亚域评分均有所改善,且与 IGF-I 变化呈负相关(r=-0.50,p=0.052)。24 个月时,ACROQOL 评分整体(从 54.3+/-21 提高至 65.7+/-18.0,p=0.04)和外观亚域评分也有所改善;然而,血清 IGF-I 浓度变化与 ACROQOL 总分变化之间无相关性(r=0.008,p=0.87)。ACRO(NC)(p=0.310)和 ACRO(C)(p=0.583)患者的 ACROQOL 评分无显著变化,而 ACRO(CC)患者的 ACROQOL 评分在整体和心理亚域均有所改善(从 42.1+/-22.1 提高至 58.8+/-16.04,p=0.021);然而,这反映了疾病控制后前 6 个月内的改善。总之,成功治疗可使疾病活动正常化,从而在短期内改善肢端肥大症患者的生活质量。然而,ACROQOL 评分在长期内无相关性可能表明除血清 IGF-I 外的其他因素也参与了肢端肥大症患者的健康状况;然而,由于样本量较小,我们的结果需要在更大的研究中进行证实。

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