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埃及儿科地中海贫血患者的生活质量结果

Quality of Life Outcomes in a Pediatric Thalassemia Population in Egypt.

作者信息

Adam Soheir, Afifi Hanan, Thomas Manal, Magdy Phoebe, El-Kamah Ghada

机构信息

a Department of Hematology , King Abdulaziz University , Jeddah , Saudi Arabia.

b Department of Medicine , Duke University Medical Center , Durham , NC , USA.

出版信息

Hemoglobin. 2017 Jan;41(1):16-20. doi: 10.1080/03630269.2017.1312434. Epub 2017 Apr 25.

DOI:10.1080/03630269.2017.1312434
PMID:28440111
Abstract

Thalassemia is a disorder of hemoglobin (Hb) synthesis characterized by chronic hemolysis. In β-thalassemias major (β-TM), patients require regular transfusion at an early age due to severe anemia. Subsequently, intensive chelation therapy is initiated to mitigate the effects of the resultant iron overload. Clinical disease burden and the demanding treatment can affect health-related quality of life (HRQoL) outcomes in this population. The aim of this study was to assess HRQoL outcomes in Egyptian pediatric thalassemia patients. Patients were enrolled simultaneously from the hematology clinic at the National Research Institute in Cairo, Egypt. The Arabic version of SF36 tool was used to assess HRQoL outcomes. Socioeconomic data were collected by patient and parent interviews. Clinical data were collected by review of medical records. One hundred and thirty patients and 60 controls were enrolled, with a mean age of 5.4 ± 3.2 years and 6.3 ± 3.0, respectively. The HRQoL outcome scores were lower in all domains in the thalassemia group compared to the control group (p = 0.0001). Transfusion-dependent (TD) patients had lower HRQoL scores compared to nontransfusion-dependent (NTD) patients (p = 0.0001). Patient education and maternal education were independently associated with better HRQoL scores (p = 0.007, p = 0.028, respectively). Residents of rural areas reported lower scores compared to urban residents (p = 0.026). Thalassemia was associated with lower HRQoL scores, in all domains, compared to HRQoL in unaffected controls. Chronic transfusion independence, patient education, and maternal education were all associated with higher HRQoL scores. Psychological, social, and economic support for families with thalassemia are all essential tools to improve HRQoL outcomes.

摘要

地中海贫血是一种以慢性溶血为特征的血红蛋白(Hb)合成障碍性疾病。在重型β地中海贫血(β-TM)中,患者由于严重贫血在幼年时就需要定期输血。随后,开始强化螯合疗法以减轻由此产生的铁过载的影响。临床疾病负担和苛刻的治疗会影响该人群与健康相关的生活质量(HRQoL)结果。本研究的目的是评估埃及儿科地中海贫血患者的HRQoL结果。患者同时从埃及开罗国家研究所以及血液学诊所招募。使用SF36工具的阿拉伯语版本来评估HRQoL结果。通过患者和家长访谈收集社会经济数据。通过查阅病历收集临床数据。共招募了130名患者和60名对照,平均年龄分别为5.4±3.2岁和6.3±3.0岁。与对照组相比,地中海贫血组所有领域的HRQoL结果得分均较低(p = 0.0001)。与非输血依赖(NTD)患者相比,输血依赖(TD)患者的HRQoL得分更低(p = 0.0001)。患者教育和母亲教育分别与更好的HRQoL得分独立相关(分别为p = 0.007,p = 0.028)。与城市居民相比,农村地区居民的得分较低(p = 0.026)。与未受影响的对照组的HRQoL相比,地中海贫血在所有领域均与较低的HRQoL得分相关。长期输血独立、患者教育和母亲教育均与较高的HRQoL得分相关。为地中海贫血家庭提供心理、社会和经济支持都是改善HRQoL结果的重要手段。

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