Che Yan-Hua, You Jing, Chongsuvivatwong Virasakdi, Li Li, Sriplung Hucha, Yan Yuan-Zhi, Ma Si-Jia, Zhang Xiaoli, Shen Ting, Chen He-Min, Rao Shao-Feng, Zhang Ru-Yi
Breast Disease Center, The First Peoples Hospital of Kunming, Yunnan province, Kunming, China E-mail :
Asian Pac J Cancer Prev. 2014;15(12):4765-71. doi: 10.7314/apjcp.2014.15.12.4765.
Patients with chronic liver diseases (CLD) may have compromised health related quality of life (HRQoL). Hepatitis B virus (HBV) infection has long been the leading cause of CLD including liver cancer and cirrhosis. Knowledge on different symptom profiles of CLD should help in development of comprehensive treatment and patient care plans.
To access the facets of HRQoL in chronic liver diseases throughout their spectrum of severity.
A cross-sectional study was conducted in the First Affiliated Hospital of Kunming Medical University in Yunnan Province of China. Both out- and inpatients undergoing treatment protocols for different HBV related liver disease states were consecutively collected from December 2012 to June 2013. ANOVA was used to compare the mean scores of EQ-5D and chronic liver disease questionnaire (CLDQ) among 5 disease groups. The relationship between demographic variables predicting global CLDQ scores and the domains of CLDQ was analysed.
A total of 1040 patients including 520 without complications, 91 with compensated cirrhosis, 198 with decompensated cirrhosis, 131 with HCC and 100 with liver failure were recruited. All domains of CLDQ, the means of EQ-5D value and EQ VAS exhibited significant decline with worsening of disease severity from uncomplicated HBV to liver failure. The multivariate regression demonstrated the reduction of mean scores of CLDQ domain at advanced stage. Patients with liver failure and HCC had more HRQoL impairment than other disease states. No effect of patient gender was found. Patient age was associated with 'fatigue' and 'worry' domains (p=0.006; p=0.004) but not with other domains and global scores of CLDQ and ED-5D.
The HRQoL in chronic hepatitis B patients is greatly affected by disease states. Care for HBV-related diseases should consider not only the outcomes of treatment strategies but also improvement in patient wellbeing.
慢性肝病（CLD）患者的健康相关生活质量（HRQoL）可能受损。长期以来，乙型肝炎病毒（HBV）感染一直是包括肝癌和肝硬化在内的慢性肝病的主要病因。了解慢性肝病的不同症状特征应有助于制定综合治疗和患者护理计划。
评估慢性肝病在其整个严重程度范围内的健康相关生活质量方面。
在中国云南省昆明医科大学第一附属医院进行了一项横断面研究。2012年12月至2013年6月连续收集接受不同HBV相关肝病状态治疗方案的门诊和住院患者。采用方差分析比较5个疾病组中EQ-5D和慢性肝病问卷（CLDQ）的平均得分。分析预测总体CLDQ得分的人口统计学变量与CLDQ各领域之间的关系。
共招募了1040名患者，其中520名无并发症，91名代偿期肝硬化，198名失代偿期肝硬化，131名肝癌，100名肝衰竭。从无并发症的HBV到肝衰竭，随着疾病严重程度的加重，CLDQ的所有领域、EQ-5D值的均值和EQ VAS均显著下降。多因素回归显示晚期CLDQ领域平均得分降低。肝衰竭和肝癌患者的健康相关生活质量损害比其他疾病状态更严重。未发现患者性别有影响。患者年龄与“疲劳”和“担忧”领域相关（p = 0.006；p = 0.004），但与CLDQ和ED-5D的其他领域及总体得分无关。
慢性乙型肝炎患者的健康相关生活质量受疾病状态的影响很大。对HBV相关疾病的护理不仅应考虑治疗策略的结果，还应考虑患者幸福感的改善。
