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通过肢端肥大症生活质量(AcroQoL)问卷评估,疾病控制和治疗方式对肢端肥大症患者的生活质量有影响。

Disease control and treatment modalities have impact on quality of life in acromegaly evaluated by Acromegaly Quality of Life (AcroQoL) Questionnaire.

作者信息

Vandeva Silvia, Yaneva Maria, Natchev Emil, Elenkova Atanaska, Kalinov Krasimir, Zacharieva Sabina

机构信息

Clinical Center of Endocrinology and Gerontology, Medical University - Sofia, Zdrave 2 str., 1431, Sofia, Bulgaria,

出版信息

Endocrine. 2015 Aug;49(3):774-82. doi: 10.1007/s12020-014-0521-6. Epub 2015 Jan 6.

Abstract

Various factors influence quality of life (QoL) in acromegaly. Whether disease control and treatment approach are related to QoL is still a matter of debate. The aim of the present study was to evaluate QoL in patients with acromegaly using the disease-specific Acromegaly Quality of Life Questionnaire in respect to disease activity, treatment modalities, and other factors. We studied 212 patients with acromegaly in a cross-sectional manner over a 6-year period in a single tertiary center. As a second step, seventy of the patients who were with active disease at baseline were followed up prospectively and 45 of them were in remission at re-evaluation. In regard to the cross-sectional group, active acromegaly independently predicted worse appearance scores. Prior radiotherapy and older age were independent negative predictors of all scales. Female gender negatively predicted all scales except the appearance domain. Longer duration of remission predicted worse personal relations scores in biochemically controlled patients. The use of somatostatin analog (SSA) was associated with worse personal relations scores, while higher IGF-1 index predicted worse appearance scores in patients with active acromegaly. In the prospective group, achievement of remission independently predicted improvement of the total scale. Lower corresponding baseline scores predicted improvement of the total, physical, and appearance scales, while the absence of hypopituitarism independently predicted improvement of the appearance scale. The use of SSA was associated with improvement of the total and appearance scores. In conclusion, QoL is a multifactorial issue that needs an individualized approach for detection and management.

摘要

多种因素影响肢端肥大症患者的生活质量(QoL)。疾病控制和治疗方法是否与生活质量相关仍是一个有争议的问题。本研究的目的是使用特定疾病的肢端肥大症生活质量问卷,从疾病活动度、治疗方式和其他因素方面评估肢端肥大症患者的生活质量。我们在一个单一的三级中心,以横断面研究的方式,对212例肢端肥大症患者进行了为期6年的研究。第二步,对70例基线时疾病活动的患者进行前瞻性随访,其中45例在重新评估时病情缓解。对于横断面研究组,活动期肢端肥大症独立预测外观评分更差。既往接受放疗和年龄较大是所有量表的独立负性预测因素。女性性别对除外观领域外的所有量表均有负性预测作用。缓解期较长预测生化指标得到控制的患者人际关系评分更差。使用生长抑素类似物(SSA)与较差的人际关系评分相关,而较高的胰岛素样生长因子-1(IGF-1)指数预测活动期肢端肥大症患者外观评分更差。在前瞻性研究组中,病情缓解独立预测总分改善。较低的相应基线评分预测总分、身体和外观量表改善,而无垂体功能减退独立预测外观量表改善。使用SSA与总分和外观评分改善相关。总之,生活质量是一个多因素问题,需要采用个体化方法进行检测和管理。

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