Nozaki Aya, Ando Takao, Akazawa Satoru, Satoh Tsuyoshi, Sagara Ikuko, Horie Ichiro, Imaizumi Misa, Usa Toshiro, Yanagisawa Robert T, Kawakami Atsushi
Division of Endocrinology and Metabolism, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Division of Endocrinology and Metabolism, Isahaya General Hospital, 24-1 Eisho-Higashi, Isahaya, Nagasaki, Japan.
Endocrine. 2016 Jan;51(1):140-7. doi: 10.1007/s12020-015-0637-3. Epub 2015 May 30.
Central diabetes insipidus (CDI) is characterized by polyuria and polydipsia due to a deficiency of vasopressin. Currently, the treatment goal for CDI is improvement of quality of life (QOL) by desmopressin (DDAVP) without developing hyponatremia. However, there is no reliable measure for QOL in CDI patients. We evaluate our original questionnaire for QOL, consisting of 12 questions focusing on polyuria, polydipsia, and DDAVP treatment, in CDI patients who underwent a switch from nasal spray to oral disintegrating tablets of DDAVP. Twenty-five CDI patients under nasal DDAVP treatment, six with newly developed CDI, and 18 healthy individuals without known polyuric/polydipsic disorders as control subjects were enrolled. QOL scores were determined by our questionnaire at the enrollment and 3 months after the start of oral DDAVP treatment and were examined by the Wilcoxon signed-rank test. Eleven questions detected improvement in QOL. The sum of the QOL scores of the eleven questions increased from 29.2 ± 5.6 under nasal to 36.8 ± 4.5 under oral DDAVP (p < 0.001). There were no clinically relevant changes in serum levels of Na. After eliminating two questions about DDAVP treatment, the sum of QOL scores was 15.3 ± 6.5 in untreated CDI patients, 24.4 ± 5.2 in those with nasal treatment, 28.9 ± 4.9 in those with oral DDAVP, and 29.5 ± 3.6 in healthy controls. The difference among groups was significant (p < 0.05 in Steel-Dwass test) except between patients treated with oral DDAVP and healthy controls. Our questionnaire can be used to accurately assess QOL in CDI patients.
中枢性尿崩症（CDI）的特征是由于抗利尿激素缺乏导致多尿和烦渴。目前，CDI的治疗目标是通过去氨加压素（DDAVP）改善生活质量（QOL），同时不发生低钠血症。然而，对于CDI患者的生活质量尚无可靠的评估方法。我们对自己设计的生活质量问卷进行了评估，该问卷由12个问题组成，重点关注多尿、烦渴和DDAVP治疗情况，研究对象为从DDAVP鼻喷雾剂转换为口腔崩解片的CDI患者。纳入了25例接受鼻用DDAVP治疗的CDI患者、6例新诊断的CDI患者以及18名无已知多尿/烦渴疾病的健康个体作为对照。在入组时和开始口服DDAVP治疗3个月后，通过我们的问卷确定生活质量评分，并采用Wilcoxon符号秩检验进行分析。11个问题显示生活质量有所改善。这11个问题的生活质量评分总和从鼻用DDAVP时的29.2±5.6提高到口服DDAVP时的36.8±4.5（p<0.001）。血清钠水平无临床相关变化。剔除两个关于DDAVP治疗的问题后，未经治疗的CDI患者生活质量评分总和为15.3±6.5，鼻用治疗患者为24.4±5.2，口服DDAVP患者为28.9±4.9，健康对照为29.5±3.6。除口服DDAVP治疗的患者与健康对照之间外，各组间差异有统计学意义（Steel-Dwass检验p<0.05）。我们的问卷可用于准确评估CDI患者的生活质量。
