Müller Jan, Berner Anne, Ewert Peter, Hager Alfred
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany.
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany.
Int J Cardiol. 2014 Aug 1;175(2):358-62. doi: 10.1016/j.ijcard.2014.06.008. Epub 2014 Jun 18.
Health-related quality of life questionnaires are frequently used to involve patients' impressions and feelings in the outcome evaluation. In patients with congenital heart disease (CHD) methodological heterogeneities, assessment in different age and diagnostic groups led to controversial findings. This study aims to give a comprehensive answer to the health-related quality of life in patients with CHD.
From July 2001 to June 2013, 2360 patients (1058 female, 28.6±11.2 years, range 14-75 years) with various kinds of CHD underwent a quality of life assessment with the SF-36 questionnaire and underwent a cardiopulmonary exercise test as part of their routine follow-up.
Physical component summary score (PCS) develops from 96.1% predicted in patients younger than 20 years, to 96.2 %predicted in patients aged 20 to 30 years, 92.3% predicted in patients aged 30 to 40 years, and 92.6% predicted in patients 40 years or older (r=-.114; p<.001). The decline was more prominent in the mental component summary score (MCS) declining from 104.1% predicted in patients younger than 20 years, to 103.4% predicted, 99.9% predicted, and 97.5% predicted (r=-.132; p<.001). Exercise capacity was impaired with 80.1±23.0% predicted and also declined slowly with age (r=-.084; p<.001).
Health-related quality of life in patients with CHD is progressively reduced in older age-groups. The decline is small, but more prominent in the mental components. This should be considered in the interpretation of studies, and strategies have to be developed to reduce this effect in future.
与健康相关的生活质量问卷经常被用于在结果评估中纳入患者的印象和感受。在先天性心脏病（CHD）患者中，方法学上的异质性、不同年龄和诊断组的评估导致了有争议的结果。本研究旨在全面回答CHD患者与健康相关的生活质量问题。
从2001年7月至2013年6月，2360例患有各种CHD的患者（1058例女性，年龄28.6±11.2岁，范围14 - 75岁）使用SF - 36问卷进行了生活质量评估，并作为常规随访的一部分进行了心肺运动测试。
身体成分汇总得分（PCS）从20岁以下患者预测的96.1%，发展到20至30岁患者预测的96.2%，30至40岁患者预测的92.3%，以及40岁及以上患者预测的92.6%（r = -0.114；p < 0.001）。这种下降在心理成分汇总得分（MCS）中更为明显，从20岁以下患者预测的104.1%，下降到预测的103.4%、99.9%和97.5%（r = -0.132；p < 0.001）。运动能力受损，为预测值的80.1±23.0%，并且也随年龄缓慢下降（r = -0.084；p < 0.001）。
CHD患者与健康相关的生活质量在老年人群中逐渐降低。下降幅度较小，但在心理成分中更为明显。在研究解释中应考虑到这一点，并且必须制定策略以在未来减少这种影响。
