Department of Physiology, Siberian Biomedical Research Center Ministry of Health Russian Federation, 15 Rechkunovskaya Street, Novosibirsk, Russia, 630055.
Department of Cardiac Surgery, Siberian Biomedical Research Center Ministry of Health Russian Federation, 15 Rechkunovskaya Street, Novosibirsk, Russia, 630055.
Qual Life Res. 2018 Mar;27(3):747-754. doi: 10.1007/s11136-017-1712-4. Epub 2017 Sep 30.
To test the hypothesis that quality of life (QoL) parameters before surgery in patients with chronic thromboembolic pulmonary hypertension (CTEPH) are influenced by clinical determinants related to the underlying disease and to examine QoL parameters affected in the long-term after the operation by complications presenting in the early postoperative period.
This prospective cohort study included 128 patients who presented with CTEPH before and after pulmonary thromboendarterectomy (PTE; 1-year follow-up). All patients were examined regarding QoL using the Short-Form 36 Health Survey Questionnaire (SF-36).
In patients with CTEPH, PTE provided immediate improvement in terms of pulmonary hemodynamic parameters and favorable effects on long-term outcome, including QoL 1 year after surgery. Multivariate analysis showed that systolic pulmonary arterial pressure, right ventricular ejection fraction, and the presence of coronary artery disease and chronic obstructive pulmonary disease (COPD) were independent factors affecting QoL on several SF-36 subscales in patients with CTEPH prior to surgery. The factors that affect patient QoL 1 year after surgery on some SF-36 subscales included the presence of coronary artery disease, COPD, heart failure, residual pulmonary hypertension, and prolonged ventilation, neurological complications in the early postoperative period of PTE.
Surgical treatment for CTEPH leads to an increase in QoL in all SF-36 subscales, excluding general health perceptions. Factors affecting QoL in patients with CTEPH included severity of pulmonary arterial hypertension, comorbidity, and complications in the early postoperative period after PTE, such as heart failure, neurologic problems, residual pulmonary hypertension, and prolonged ventilation.
检验假设，即慢性血栓栓塞性肺动脉高压（CTEPH）患者手术前的生活质量（QoL）参数受与潜在疾病相关的临床决定因素影响，并检查手术后早期出现的并发症对长期 QoL 参数的影响。
本前瞻性队列研究纳入了 128 例接受肺动脉血栓内膜切除术（PTE）治疗的 CTEPH 患者（1 年随访）。所有患者均使用健康调查简表 36 项（SF-36）进行 QoL 评估。
在 CTEPH 患者中，PTE 可立即改善肺血流动力学参数，并对长期预后产生有利影响，包括术后 1 年的 QoL。多变量分析显示，收缩压肺动脉压、右心室射血分数以及冠状动脉疾病和慢性阻塞性肺疾病（COPD）的存在是影响 CTEPH 患者手术前 SF-36 多个亚量表 QoL 的独立因素。影响术后 1 年 SF-36 部分亚量表患者 QoL 的因素包括冠状动脉疾病、COPD、心力衰竭、残余肺动脉高压和通气延长、PTE 术后早期的神经并发症。
针对 CTEPH 的手术治疗可提高所有 SF-36 亚量表的 QoL，除了一般健康感知。影响 CTEPH 患者 QoL 的因素包括肺动脉高压的严重程度、合并症以及 PTE 术后早期的并发症，如心力衰竭、神经问题、残余肺动脉高压和通气延长。
