希腊血友病患者的健康相关生活质量及其与关节病的关联

Health-Related Quality of Life and Association With Arthropathy in Greek Patients with Hemophilia.

作者信息

Varaklioti Agoritsa, Kontodimopoulos Nick, Niakas Dimitris, Kouramba Anna, Katsarou Olga

机构信息

1 Blood Center and National Centre for Congenital Bleeding Disorders, Laiko General Hospital, Athens, Greece.

2 Faculty of Social Sciences, Department of Health Management, Hellenic Open University, Patras, Greece.

出版信息

Clin Appl Thromb Hemost. 2018 Jul;24(5):815-821. doi: 10.1177/1076029617733041. Epub 2017 Oct 9.

Abstract

Health-related quality of life (HRQoL) is increasingly implicated in contemporary hemophilia management. This study focuses on the assessment of HRQoL in Greek patients with hemophilia and the comparison with normative data from the general population, as well as on the extent arthropathy may affect the patients' HRQoL. One hundred and nine adult patients completed the Greek social functioning (SF-36) and Haem-A-QoL questionnaires. Arthropathy was assessed by both the World Federation of Hemophilia clinical score and Pettersson radiological score. The most impaired domains of Haem-A-QoL were sports/leisure (SL) and physical health (PH; mean scores 61.2 and 42.2, respectively). The patients experienced statistically significant lower mean scores in all SF-36 domains than the normative sample, especially in role physical (RPH), bodily pain (BP), and general health (GH) subscales. Among Haem-A-QoL subscales, SL and PH were found strongly associated with severity of arthropathy using both orthopedic scores ( P < .001), and maintained the statistical significance after adjustment for age ( P < .05). A poor orthopedic status was also negatively associated with certain SF-36 subscales. However, none of these correlations remained after adjustment with age. Compared to normative data from Greece, patients with hemophilia showed deterioration in all HRQoL subscales, with a more pronounced effect in RPH, BP, and GH subscales. Health-related quality of life was strongly influenced by arthropathy, mainly in the physical aspects of HRQoL. The use of the disease-specific Haem-A-QoL tool can capture additional associations between HRQoL and hemophilic arthropathy.

摘要

健康相关生活质量(HRQoL)在当代血友病管理中所起的作用日益受到关注。本研究聚焦于评估希腊血友病患者的健康相关生活质量,并与普通人群的标准数据进行比较,同时关注关节病对患者健康相关生活质量的影响程度。109名成年患者完成了希腊社会功能(SF - 36)问卷和血友病生活质量(Haem - A - QoL)问卷。通过世界血友病联盟临床评分和彼得松放射学评分对关节病进行评估。Haem - A - QoL问卷中受损最严重的领域是运动/休闲(SL)和身体健康(PH;平均得分分别为61.2和42.2)。与标准样本相比,患者在所有SF - 36领域的平均得分均有统计学意义的降低,尤其是在身体功能(RPH)、身体疼痛(BP)和总体健康(GH)子量表方面。在Haem - A - QoL子量表中,使用两种骨科评分方法均发现SL和PH与关节病严重程度密切相关(P <.001),在调整年龄后仍保持统计学意义(P <.05)。骨科状况不佳也与某些SF - 36子量表呈负相关。然而,在调整年龄后,这些相关性均不再显著。与希腊的标准数据相比,血友病患者在所有健康相关生活质量子量表中均表现出恶化,在RPH、BP和GH子量表中影响更为明显。健康相关生活质量受到关节病的强烈影响,主要体现在健康相关生活质量的身体方面。使用特定疾病的Haem - A - QoL工具可以发现健康相关生活质量与血友病性关节病之间的其他关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce77/6714871/e6518e2e2ecb/10.1177_1076029617733041-fig1.jpg

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