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家族性高胆固醇血症会降低未达到治疗目标的患者的生活质量。

Familial hypercholesterolaemia reduces the quality of life of patients not reaching treatment targets.

作者信息

Mortensen Gitte Lee, Madsen Ivan Bredbjerg, Kruse Charlotte, Bundgaard Henning

出版信息

Dan Med J. 2016 May;63(5).

Abstract

INTRODUCTION

Familial hypercholesterolaemia (FH) is the most common monogenic disorder associated with premature cardiovascular disease. If untreated, life expectancy in heterozygous FH patients is shortened by 20-30 years compared with the general population. Nevertheless, treatment goals are only met in approximately 50% of patients. This comparative study examined the quality of life (QoL) impact of FH in patients who had and had not reached the target of treatment.

METHODS

Two qualitative focus group interviews were carried out with a total of ten FH patients. A semi-structured interview guide included questions identified in a preceding literature study. The data were analysed using a medical anthropological approach.

RESULTS

While having FH did not have much impact on well-treated patients' QoL, patients who had not reached the treatment target had markedly more concerns. They had experienced severe side-effects and worried about their own and their relatives' health. They were concerned about the long-term impact of not being effectively treated including the risk that coronary heart disease could cause their premature death or disability and inability to care for their children, in particular. The women had issues with stigma and self-efficacy.

CONCLUSIONS

The QoL impact of FH is related to treatment efficacy. These findings need to be addressed in the management of FH patients. Particular attention should be paid to those who are not presently reaching the target of treatment.

FUNDING

The study was funded by a research grant from Amgen.

TRIAL REGISTRATION

not relevant.

摘要

引言

家族性高胆固醇血症(FH)是与早发性心血管疾病相关的最常见单基因疾病。若不治疗,杂合子FH患者的预期寿命比普通人群缩短20 - 30年。然而,只有约50%的患者达到治疗目标。这项比较研究考察了FH对已达到和未达到治疗目标的患者生活质量(QoL)的影响。

方法

对总共10名FH患者进行了两次定性焦点小组访谈。一份半结构化访谈指南包含了先前文献研究中确定的问题。使用医学人类学方法对数据进行分析。

结果

虽然患有FH对治疗良好的患者的生活质量影响不大,但未达到治疗目标的患者有明显更多的担忧。他们经历了严重的副作用,担心自己和亲属的健康。他们担心未得到有效治疗的长期影响,包括冠心病可能导致过早死亡或残疾的风险,特别是无法照顾自己的孩子。女性存在耻辱感和自我效能方面的问题。

结论

FH对生活质量的影响与治疗效果相关。这些发现需要在FH患者的管理中加以解决。应特别关注那些目前未达到治疗目标的患者。

资金来源

该研究由安进公司的一项研究资助提供资金。

试验注册

不相关。

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