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656 例原发性免疫缺陷儿童的不良健康状况和生活质量负担。

Burden of Poor Health Conditions and Quality of Life in 656 Children with Primary Immunodeficiency.

机构信息

Department of Pediatric Hematology-Oncology, Assistance Publique-Hôpitaux de Marseille, Marseille, France; French National Reference Center for Primary Immune Deficiency (CEREDIH), Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Department of Public Health-EA 3279 Research Unit, Aix-Marseille University, Provence, France.

French National Reference Center for Primary Immune Deficiency (CEREDIH), Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Pediatric Immuno-Haematology and Rheumatology Unit, Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR1163, Imagine Institute, Sorbonne Paris Cité, University Paris Descartes, Paris, France.

出版信息

J Pediatr. 2018 Mar;194:211-217.e5. doi: 10.1016/j.jpeds.2017.10.029. Epub 2017 Dec 6.

Abstract

OBJECTIVE

To gain insight into how primary immunodeficiencies (PIDs) affect children's health status and quality of life.

STUDY DESIGN

The French Reference Center for PIDs conducted a prospective multicenter cohort that enrolled participants who met all criteria: patients included in the French Reference Center for PIDs registry, children younger than18 years, and living in France. Participants were asked to complete both a health questionnaire and a health-related quality of life (HR-QoL) questionnaire. A severity score was assigned to each health condition: grade 1 (mild) to grade 4 (life-threatening). HR-QoL in children was compared with age- and sex-matched French norms.

RESULTS

Among 1047 eligible children, 656 were included in the study, and 117 had undergone hematopoietic stem cell transplantation; 40% experienced at least one grade 4 condition, and 83% experienced at least one grade 3 or 4 condition. Compared with the French norms, children with PID scored significantly lower for most HR-QoL domains. Low HR-QoL scores were associated strongly with burden of poor conditions.

CONCLUSIONS

Our results quantify the magnitude of conditions in children with PID and demonstrate that the deleterious health effects borne by patients already are evident in childhood. These results emphasize the need to closely monitor this vulnerable population and establish multidisciplinary healthcare teams from childhood.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT02868333 and EudraCT 2012-A0033-35.

摘要

目的

了解原发性免疫缺陷病(PID)如何影响儿童的健康状况和生活质量。

研究设计

法国 PID 参考中心进行了一项前瞻性多中心队列研究,纳入符合所有标准的参与者:PID 法国参考中心登记册中的患者、年龄小于 18 岁且居住在法国的患者。参与者被要求完成健康问卷和健康相关生活质量(HR-QoL)问卷。为每个健康状况分配一个严重程度评分:1 级(轻度)至 4 级(危及生命)。将儿童的 HR-QoL 与年龄和性别匹配的法国标准进行比较。

结果

在 1047 名符合条件的儿童中,有 656 名纳入研究,其中 117 名接受了造血干细胞移植;40%的儿童至少经历过 1 种 4 级疾病,83%的儿童至少经历过 1 种 3 级或 4 级疾病。与法国标准相比,PID 儿童在大多数 HR-QoL 领域的得分明显较低。HR-QoL 评分较低与不良状况负担密切相关。

结论

我们的研究结果量化了 PID 儿童的疾病严重程度,并表明患者已经在童年时期就承受着有害的健康影响。这些结果强调了需要密切监测这一弱势群体,并从儿童时期开始建立多学科医疗保健团队。

试验注册

ClinicalTrials.gov:NCT02868333 和 EudraCT 2012-A0033-35。

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