Sinakos E, Gigi E, Lalla T, Bellou A-L, Sykja A, Orphanou E, Vrettou E, Tsapas V, Raptopoulou M
Hippokratia. 2010 Apr;14(2):122-5.
Background - Aims: Chronic hepatitis C (CHC) can cause a series of neuropsychiatric symptoms, whereas the currently approved treatment for this disease often induces similar symptoms as well. The aim of the present study was to compare Greek CHC patients' health-related quality of life (HRQoL) with that of healthy controls, to identify any possible relationships between HRQoL and demographic and laboratory parameters and to study the fluctuation of HRQoL during therapy and follow-up.
Ninty nine patients with CHC and 91 healthy controls were enrolled in the study. ALT, viral load, HCV genotype, fibrosis stage by liver biopsy and BMI, were determined at baseline. All patients completed the SF-36 quality of life questionnaire, which was self-administered, before treatment. They were treated with pegylated interferon alpha2-a or alpha-2b and ribavirin for 24 or 48 weeks and evaluated in the middle of therapy, at the end and six months after treatment cessation. SF-36 questionnaire was also completed in each evaluation.
Patients' HRQoL was found to be below that of healthy controls in all SF-36 scales before treatment. There was a significant negative association between history of drug abuse and general health and a positive association between age and mental health. Multivariate analysis revealed that history of drug abuse seemed to play a significant role in bodily pain and general health of patients, as well as age did in vitality and mental health. The course of patients' HRQoL showed that in the middle of treatment values in all SF-36 scales were below those of baseline and they returned to pretreatment levels at the end of therapy. However, at the end of the six month follow-up period, an improvement in almost all scales compared to baseline was noted.
Our results showed that a) Greek CHC patients' HRQoL was worse than that of healthy individuals and fluctuated significantly during treatment b) A history of drug abuse and age can independently affect HRQoL c) During treatment values of HRQoL are worsened possibly due to interferon-a treatment and d) In the long-term treatment results in improvement of HRQoL.
背景 - 目的：慢性丙型肝炎（CHC）可引发一系列神经精神症状，而目前批准用于该疾病的治疗方法也常常诱发类似症状。本研究的目的是比较希腊CHC患者与健康对照者的健康相关生活质量（HRQoL），确定HRQoL与人口统计学和实验室参数之间的任何可能关系，并研究治疗和随访期间HRQoL的波动情况。
99例CHC患者和91例健康对照者纳入本研究。在基线时测定谷丙转氨酶（ALT）、病毒载量、HCV基因型、肝活检纤维化分期和体重指数（BMI）。所有患者在治疗前自行完成SF - 36生活质量问卷。他们接受聚乙二醇化干扰素α2 - a或α - 2b与利巴韦林治疗24或48周，并在治疗中期、结束时以及停药后6个月进行评估。每次评估时也完成SF - 36问卷。
治疗前所有SF - 36量表中患者的HRQoL均低于健康对照者。药物滥用史与总体健康之间存在显著负相关，年龄与心理健康之间存在正相关。多因素分析显示，药物滥用史似乎在患者的身体疼痛和总体健康方面发挥重要作用，年龄在活力和心理健康方面也有类似作用。患者HRQoL的变化过程表明，治疗中期所有SF - 36量表的值均低于基线，治疗结束时恢复到治疗前水平。然而，在6个月随访期末，与基线相比几乎所有量表均有改善。
我们的结果表明，a）希腊CHC患者的HRQoL比健康个体差，且在治疗期间波动显著；b）药物滥用史和年龄可独立影响HRQoL；c）治疗期间HRQoL值可能因干扰素 - a治疗而恶化；d）长期治疗可改善HRQoL。
