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β-地中海贫血患者输血加螯合治疗与骨髓移植的比较:SF-36、EQ-5D 和视觉模拟量表的应用。

Comparison of Blood Transfusion Plus Chelation Therapy and Bone Marrow Transplantation in Patients with β-Thalassemia: Application of SF-36, EQ-5D, and Visual Analogue Scale Measures.

机构信息

Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.

Health Economics Department, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Int J Health Policy Manag. 2015 Jun 13;4(11):733-40. doi: 10.15171/ijhpm.2015.113.

Abstract

BACKGROUND

β-Thalassemia is a prevalent genetic disease in Mediterranean countries. The most common treatments for this disease are blood transfusion plus iron chelation (BTIC) therapy and bone marrow transplantation (BMT). Patients using these procedures experience different health-related quality of life (HRQoL). The purpose of the present study was to measure HRQoL in these patients using 2 different multiattribute quality of life (QoL) scales.

METHODS

In this cross-sectional study, data were gathered using 3 instruments: a socio-demographic questionnaire, EQ-5D, and SF-36. A total of 196 patients with β-thalassemia were randomly selected from 2 hospitals in Shiraz (Southern Iran). Data were analyzed using logistic regression and multiple regression models to identify factors that affect the patients' HRQoL.

RESULTS

The average EQ-5D index and EQ visual analog scale (VAS) scores were 0.86 (95% CI: 0.83-0.89) and 71.85 (95% CI: 69.13-74.58), respectively. Patients with BMT reported significantly higher EQ VAS scores (83.27 vs 68.55, respectively). The results showed that patients who lived in rural area and patients with BMT reported higher EQ VAS scores (rural; β= 10.25, P = .006 and BMT; β= 11.88, P = .000). As well, SF-36 between 2 groups of patients were statistically significant in physical component scale (PCS).

CONCLUSION

Patients in the BMT group experienced higher HRQoL in both physical and mental aspects compared to those in the BTIC group. More studies are needed to assess the relative cost-effectiveness of these methods in developing countries.

摘要

背景

β-地中海贫血是地中海国家常见的遗传性疾病。该病的常见治疗方法是输血加铁螯合(BTIC)疗法和骨髓移植(BMT)。使用这些方法的患者经历不同的健康相关生活质量(HRQoL)。本研究的目的是使用 2 种不同的多属性生活质量(QoL)量表来衡量这些患者的 HRQoL。

方法

在这项横断面研究中,使用 3 种工具收集数据:社会人口统计学问卷、EQ-5D 和 SF-36。从伊朗南部设拉子的 2 家医院随机抽取 196 名β-地中海贫血患者。使用逻辑回归和多元回归模型分析数据,以确定影响患者 HRQoL 的因素。

结果

EQ-5D 指数和 EQ 视觉模拟量表(VAS)评分的平均值分别为 0.86(95%CI:0.83-0.89)和 71.85(95%CI:69.13-74.58)。接受 BMT 的患者报告的 EQ VAS 评分明显更高(分别为 83.27 和 68.55)。结果表明,居住在农村地区和接受 BMT 的患者报告的 EQ VAS 评分较高(农村地区;β=10.25,P=.006 和 BMT;β=11.88,P=.000)。同样,两组患者的 SF-36 在生理成分量表(PCS)上存在统计学差异。

结论

与 BTIC 组相比,BMT 组患者在生理和心理方面的 HRQoL 更高。需要更多的研究来评估这些方法在发展中国家的相对成本效益。

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