Bloom R D, Bolin P, Gandra S R, Scarlata D, Petersen J
Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Transplant Proc. 2011 Jun;43(5):1593-600. doi: 10.1016/j.transproceed.2011.02.009.
Posttransplant anemia (PTA) is a common, multifactorial condition that has a substantial negative impact on patients' health-related quality of life (HRQOL). Erythropoietin-stimulating agents are an effective treatment for PTA, but there is little research on HRQOL in posttransplant patients. This multicenter, prospective study enrolled adults with PTA (hemoglobin [Hb] < 11.0 g/dL). Subjects (n = 66) received subcutaneous darbepoetin alfa every 2 weeks for 24 weeks. Hb and patient-reported outcomes using the Short Form (SF)-36 questionnaire were assessed. Mean (standard deviation) Hb concentration increased from 9.9 (1.2) g/dL at baseline to 11.7 (1.3) g/dL during the evaluation period (14 to 24 weeks). At baseline, SF-36 scores in all the eight domains were lower (worse) compared with the general population and patients with other chronic conditions. In subjects with baseline Hb < 10 g/dL, SF-36 subscales and component summary scores were lower than in subjects with Hb ≥ 10 g/dL. Following treatment with darbepoetin alfa, statistically significant improvements were observed for all subjects in physical component summary (0.5 points, P < .001), physical functioning (11.8 points, P = .001), limitations due to physical health (26.5 points, P < .001), bodily pain (7.7 points, P = .01), limitations due to emotional health (15.7 points, P = .01), and vitality (12.8 points, P < .001) from baseline to week 24. Clinically significant improvements (>5 points) were observed in six subscales: physical functioning, limitations due to physical health, limitations due to emotional health, bodily pain, social functioning, and vitality. Darbepoetin alfa in kidney transplant recipients with PTA significantly increased Hb concentrations and improved HRQOL scores.
移植后贫血(PTA)是一种常见的多因素病症,对患者的健康相关生活质量(HRQOL)有重大负面影响。促红细胞生成素刺激剂是治疗PTA的有效方法,但关于移植后患者HRQOL的研究较少。这项多中心前瞻性研究纳入了患有PTA(血红蛋白[Hb]<11.0 g/dL)的成年人。受试者(n = 66)每2周皮下注射一次达贝泊汀α,共24周。使用简短形式(SF)-36问卷评估Hb和患者报告的结果。在评估期(14至24周),平均(标准差)Hb浓度从基线时的9.9(1.2)g/dL增加到11.7(1.3)g/dL。在基线时,与普通人群和患有其他慢性病的患者相比,所有八个领域的SF-36评分均较低(较差)。在基线Hb<10 g/dL的受试者中,SF-36分量表和综合得分低于Hb≥10 g/dL的受试者。在用达贝泊汀α治疗后,所有受试者在身体综合得分(0.5分,P<.001)、身体功能(11.8分,P = .001)、因身体健康导致的限制(26.5分,P<.001)、身体疼痛(7.7分,P = .01)、因情绪健康导致的限制(15.7分,P = .01)和活力(12.8分,P<.001)方面从基线到第24周均有统计学上的显著改善。在六个分量表中观察到具有临床意义的改善(>5分):身体功能、因身体健康导致的限制、因情绪健康导致的限制、身体疼痛、社会功能和活力。达贝泊汀α对患有PTA的肾移植受者可显著提高Hb浓度并改善HRQOL评分。