Limbers Christine A, Neighbors Katie, Martz Karen, Bucuvalas John C, Webb Thomas, Varni James W, Alonso Estella M
Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA.
Pediatr Transplant. 2011 May;15(3):245-53. doi: 10.1111/j.1399-3046.2010.01453.x. Epub 2010 Dec 29.
This cross-sectional, multicenter cohort study compares the level of HRQOL of pediatric LT recipients to children with other chronic health conditions. LT sample included 873 children who survived at least 12 months following LT. Six chronic disease samples were compiled from numerous studies, including over 800 patients with JRA, type 1 diabetes, cancer in remission, cardiac disease, end-stage renal disease, and inflammatory bowel disease. Generic HRQOL was measured from both the parental and patient perspective using the PedsQL™ 4.0 Generic Core Scales. Pediatric LT patients reported better physical health than children with JRA. According to parents, pediatric LT recipients had better HRQOL than children on renal dialysis on all domains except school functioning. Across all domains but emotional functioning, pediatric LT recipients reported significantly lower HRQOL than children with type 1 diabetes. Overall, pediatric LT patients reported HRQOL comparable to that of children who had undergone renal transplantation and patients with cancer in remission. Pediatric LT patients manifested impaired HRQOL similar to that of children with chronic diseases and these data suggest that they face ongoing challenges that warrant monitoring and indicate a need for interventions to improve their HRQOL.
这项横断面多中心队列研究比较了小儿肝移植受者与患有其他慢性健康状况儿童的健康相关生活质量(HRQOL)水平。肝移植样本包括873名肝移植后存活至少12个月的儿童。从众多研究中汇编了六个慢性病样本,包括800多名青少年类风湿性关节炎(JRA)、1型糖尿病、癌症缓解期、心脏病、终末期肾病和炎症性肠病患者。使用儿童生活质量量表(PedsQL™)4.0通用核心量表从家长和患者的角度测量通用HRQOL。小儿肝移植患者报告的身体健康状况优于JRA儿童。家长报告称,小儿肝移植受者在除学校功能外的所有领域的HRQOL均优于接受肾透析的儿童。在除情绪功能外的所有领域,小儿肝移植受者报告的HRQOL显著低于1型糖尿病儿童。总体而言,小儿肝移植患者报告的HRQOL与接受肾移植的儿童和癌症缓解期患者相当。小儿肝移植患者表现出与慢性病儿童相似的HRQOL受损情况,这些数据表明他们面临持续的挑战,需要进行监测,并表明需要采取干预措施来改善他们的HRQOL。