Lubberts Bart, Paulino Pereira Nuno Rui, Kabrhel Christopher, Kuter David J, DiGiovanni Christopher W
Bart Lubberts, MD, Orthopaedic Foot and Ankle Service, Massachusetts General Hospital - Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA, Tel.: +1 857 389 2495, E-mail:
Thromb Haemost. 2016 Aug 30;116(3):417-31. doi: 10.1160/TH16-02-0152. Epub 2016 Jun 30.
We conducted a meta-analysis of the literature to 1) assess the health-related quality of life for patients with a minimum follow-up of one year after an episode of pulmonary embolism (PE) or deep-vein thrombosis (DVT), and 2) to assess the HRQOL for patients who develop chronic thromboembolic pulmonary hypertension (CTEPH) and post thrombotic syndrome (PTS). PubMed, EMBASE, and the Cochrane Library were searched from inception to March 30, 2016. Data were pooled using random-effects meta-analysis, and heterogeneity was assessed with I² and Tau² tests. SF-12, SF-36, and VEINES-QOL were evaluated with pooled standardised mean difference (SMD) and 95 % confidence intervals (CI). Fourteen studies were included for meta-analysis. In patients who sustain a PE, physical health becomes impaired (p<0.001, 2 studies) but mental health appears to remain similar to population norms (p=0.069, 2 studies) after at least one year. Patients who develop CTEPH report worse physical (p<0.001, 1 study) and mental health (p=0.009, 1 study). In patients who suffer from a DVT, physical health (p=0.19, 9 studies), mental health (p=0.67, 9 studies), and disease specific quality of life (p=0.61, 8 studies) remain similar to population norms after at least one year. Patients who develop PTS, however, report worse physical health (p<0.001, 7 studies), mental health (p<0.001, 7 studies), and disease specific quality of life (p<0.001, 10 studies). These data can be used to educate patients during the shared decision making process that increasingly governs medical care today.
II.
我们对文献进行了一项荟萃分析，以：1）评估肺栓塞（PE）或深静脉血栓形成（DVT）发作后至少随访一年的患者的健康相关生活质量；2）评估发生慢性血栓栓塞性肺动脉高压（CTEPH）和血栓后综合征（PTS）的患者的健康相关生活质量。检索了PubMed、EMBASE和Cochrane图书馆，检索时间从数据库建立至2016年3月30日。使用随机效应荟萃分析汇总数据，并用I²和Tau²检验评估异质性。用汇总标准化均数差（SMD）和95%置信区间（CI）评估SF-12、SF-36和VEINES-QOL。纳入14项研究进行荟萃分析。在发生PE的患者中，至少一年后身体健康受损（p<0.001，2项研究），但心理健康似乎与人群标准相似（p=0.069，2项研究）。发生CTEPH的患者报告身体（p<0.001，1项研究）和心理健康较差（p=0.009，1项研究）。在发生DVT的患者中，至少一年后身体健康（p=0.19，9项研究）、心理健康（p=0.67，9项研究）和疾病特异性生活质量（p=0.61，8项研究）与人群标准相似。然而，发生PTS的患者报告身体健康较差（p<0.001，7项研究）、心理健康较差（p<0.001，7项研究）和疾病特异性生活质量较差（p<0.001，10项研究）。这些数据可用于在如今越来越多地主导医疗护理的共同决策过程中对患者进行教育。
II级。
