Limonard G J M, Peters J B, Besselink R, Groot C A R, Dekhuijzen P N R, Vercoulen J H, Nabuurs-Franssen M H
Department of Pulmonary Diseases,Diakonessenhuis,Utrecht,The Netherlands.
Department of Medical Psychology,Radboud University Nijmegen Medical Centre,Nijmegen,The Netherlands.
Epidemiol Infect. 2016 Apr;144(6):1142-7. doi: 10.1017/S0950268815002216. Epub 2015 Oct 28.
A significant proportion of Q fever patients from the first Dutch Q fever outbreak in 2007 showed impairment in health status up to 1 year after infection. Interested in whether this decrease in health status persisted, we set out to determine the health status in the same cohort of patients, 4 years after primary infection and to compare health status scores at the individual patient level between 1 and 4 years follow-up. Health status was assessed with the Nijmegen Clinical Screening Instrument (NCSI). Patients were serologically tested to exclude patients with possible, probable or proven chronic Q fever. Results on the NCSI sub-domains at group level [2008 (n = 54) and 2011 (n = 46)] showed a persistent significant percentage of patients exhibiting clinically relevant ('severe') scores for all NCSI sub-domains. After 4 years, undue fatigue was present in 46% and exactly half of all patients experienced a severely impaired general quality of life. Patients with NCSI scores available in both 2008 and 2011 (n = 37) showed no difference in all sub-domain scores, except for a small decrease in dyspnoea emotions in 2011. In this group, a significant proportion of patients either improved or worsened in one or more sub-domains of health status. We conclude that at the group level, health status of Q fever patients remained impaired 4 years after primary infection. At the individual patient level, health status may change.
在2007年荷兰首次Q热疫情中，相当一部分Q热患者在感染后长达1年的时间里健康状况出现受损。出于对这种健康状况下降是否持续存在的兴趣，我们着手确定同一批患者在初次感染4年后的健康状况，并比较随访1年和4年时个体患者的健康状况评分。使用奈梅亨临床筛查工具（NCSI）评估健康状况。对患者进行血清学检测，以排除可能、很可能或确诊为慢性Q热的患者。在组水平上[2008年（n = 54）和2011年（n = 46）]NCSI子领域的结果显示，所有NCSI子领域中持续有相当比例的患者表现出具有临床相关性（“严重”）的评分。4年后，46%的患者存在过度疲劳，所有患者中有一半的人总体生活质量严重受损。在2008年和2011年都有NCSI评分的患者（n = 37）中，除了2011年呼吸困难情绪略有下降外，所有子领域评分均无差异。在该组中，相当一部分患者在一个或多个健康状况子领域中有所改善或恶化。我们得出结论，在组水平上，Q热患者在初次感染4年后健康状况仍然受损。在个体患者水平上，健康状况可能会发生变化。
