Department of Pediatrics, Eulji University School of Medicine, Daejeon, Korea.
Haemophilia. 2013 Jul;19(4):637-41. doi: 10.1111/hae.12131. Epub 2013 Apr 10.
The minimum goal of secondary prophylaxis may be to delay the progression of haemarthropathy below a critical level over which it has a great impact on the QoL of haemophilia patients. However, the critical level of haemarthropathy may be different across countries. For these reasons, the impact of haemarthropathy on the QoL in Korean haemophilia A patients was investigated. Depending on observed Pettersson scores of 27 severe haemophilia A patients, they were divided into three groups, P (Pettersson score) ≤ 10, P1119 and P ≥ 20 groups. The QoL of each patient, assessed by the SF36, was compared between the groups. In addition, the changes in the QoL of the patients were observed according to the changes of Pettersson scores to find out the critical level of arthropathy. None of the scores of the SF36 scales were different between the P ≤ 10 and P1119 groups. In contrast, the scores of PF and MH scales were significantly different between the P11~19 and P ≥ 20 groups. When changes in the scores of each scale in the SF36 were observed according to changes in Pettersson scores, the average P score of 13.0 ± 2.7 was thought to be the critical level of haemarthropathy because above that level, haemarthropathy and physical and mental health of the patients rapidly deteriorated. The progression of haemarthropathy to the critical level should be delayed as long as possible to prevent or to delay a rapid deterioration of the QoL of Korean patients with haemophilia.
二级预防的最低目标可能是延迟关节积血进展至对血友病患者生活质量(QoL)有重大影响的临界水平以下。然而,关节积血的临界水平在不同国家可能有所不同。基于这些原因,研究了关节积血对韩国血友病 A 患者 QoL 的影响。根据 27 例重度血友病 A 患者观察到的 Pettersson 评分,将他们分为三组,P(Pettersson 评分)≤10、P1119 和 P≥20 组。使用 SF36 评估每位患者的 QoL,并对各组之间进行比较。此外,根据 Pettersson 评分的变化观察患者 QoL 的变化,以找出关节病的临界水平。SF36 量表的评分在 P≤10 和 P1119 组之间没有差异。相比之下,P11~19 和 P≥20 组之间 PF 和 MH 量表的评分有显著差异。当根据 Pettersson 评分的变化观察 SF36 中各量表评分的变化时,认为平均 P 评分为 13.0±2.7 是关节积血的临界水平,因为在此水平以上,关节积血和患者的身心健康迅速恶化。应尽可能延迟关节积血进展至临界水平,以预防或延缓韩国血友病患者 QoL 的快速恶化。