Psaras T, Honegger J, Gallwitz B, Milian M
Department of Neurosurgery, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, Tuebingen, Germany.
Exp Clin Endocrinol Diabetes. 2011 May;119(5):300-5. doi: 10.1055/s-0030-1267912. Epub 2010 Oct 28.
Acromegaly is associated with deleterious comorbidities that can remain irreversible even after successful cure has been achieved and lead to a persistently impaired Quality of Life (QoL). The aim of the study was to assess frequency and degree of persistent comorbidities and complaints after treatment of acromegaly and to investigate their impact on QoL. Another scope of interest was to determine gender-specific factors that influence perceived QoL in men and women.
We developed an Acromegaly Comorbidities & Complaints Questionnaire (ACCQ) consisting of 8 items (e. g. acral enlargement, joint complaints, hypertension, diabetes) known to affect QoL in order to assess frequency and degree of comorbidities. Additionally, the Acromegaly Quality of Life Questionnaire (AcroQoL) and the Short-form 36 (SF-36) questionnaire were handed out to 55 treated acromegalic patients.
Both genders suffer from a lasting impairment in quality of life to a considerable degree. Complaints impairing manual skills (e. g. acral enlargement, arthralgias) were the most frequent findings (73% of all participants) in both genders. Multivariate analyses revealed that in men numbness of fingers and persistent joint-complaints were decisively responsible for impaired QoL. In women, it was the persistence of hypertension.
Persistent joint complaints have adverse effects on QoL after treatment of acromegaly in men, possibly because they lead to impairment of manual motor skills and a handicap in their working life. Women seem to perceive late effects of hypertension as a manifest health threat.
肢端肥大症与有害的合并症相关,即使在成功治愈后,这些合并症仍可能无法逆转,并导致生活质量(QoL)持续受损。本研究的目的是评估肢端肥大症治疗后持续性合并症和不适的频率及程度,并调查它们对生活质量的影响。另一个感兴趣的方面是确定影响男性和女性生活质量认知的性别特异性因素。
我们编制了一份肢端肥大症合并症及不适问卷(ACCQ),其中包含8个项目(如肢端肥大、关节不适、高血压、糖尿病),这些项目已知会影响生活质量,以评估合并症的频率和程度。此外,还向55名接受治疗的肢端肥大症患者发放了肢端肥大症生活质量问卷(AcroQoL)和简短健康调查问卷(SF-36)。
男性和女性的生活质量均在很大程度上受到持续损害。影响手工技能的不适(如肢端肥大、关节痛)是男性和女性中最常见的症状(占所有参与者的73%)。多变量分析显示,在男性中,手指麻木和持续性关节不适是生活质量受损的决定性因素。在女性中,则是高血压的持续性。
持续性关节不适对男性肢端肥大症治疗后的生活质量有不利影响,可能是因为它们导致手工运动技能受损和工作生活中的障碍。女性似乎将高血压的晚期影响视为明显的健康威胁。