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自身免疫性肝炎患儿和青少年健康相关生活质量下降。

Decreased health-related quality of life in children and adolescents with autoimmune hepatitis.

机构信息

Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Pediatria, São Paulo, SP, Brazil.

Universidade Federal do Mato Grosso (UFMT), Departamento de Clínicas, Cuiabá, MT, Brazil.

出版信息

J Pediatr (Rio J). 2019 Jan-Feb;95(1):87-93. doi: 10.1016/j.jped.2017.10.013. Epub 2018 Jan 10.

Abstract

OBJECTIVE

The objective of this study was to evaluate the health-related quality of life in children and adolescents with autoimmune hepatitis.

METHODS

A cross-sectional assessment with the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) was completed for 80 patients with autoimmune hepatitis and 45 healthy controls. Demographic data, prednisone dose, disease remission state, disease severity, and abdominal pain were also evaluated.

RESULTS

Based on the child self-reports, physical, emotional, school, and total scores were significantly lower in autoimmune hepatitis patients when compared with controls (p<0.05). Based on the parental reports, only the physical and total scores were significantly lower in autoimmune hepatitis patients versus controls (p<0.05). Further analysis in autoimmune hepatitis patients with abdominal pain in the last month revealed significantly lower physical, social, and total median scores (p<0.05). No differences were observed based on disease remission state or disease severity (p>0.05). Autoimmune hepatitis patients who received a prednisone dose below 0.16mg/kg/day at the time of the interview showed significantly higher physical scores than those who received a dose similar to or above 0.16mg/kg/day (87.5 [50-100] vs. 75 [15.63-100], p=0.006).

CONCLUSIONS

Reduced scores in the physical, emotional, and school domains were observed in pediatric autoimmune hepatitis patients compared to control patients. Abdominal pain and corticosteroid dose negatively influenced the health-related quality of life in children and adolescents with autoimmune hepatitis.

摘要

目的

本研究旨在评估自身免疫性肝炎患儿和青少年的健康相关生活质量。

方法

采用儿童生活质量量表 4.0(PedsQL 4.0)对 80 例自身免疫性肝炎患儿和 45 例健康对照进行横断面评估。还评估了人口统计学数据、泼尼松剂量、疾病缓解状态、疾病严重程度和腹痛。

结果

根据儿童自我报告,与对照组相比,自身免疫性肝炎患儿的身体、情感、学校和总分明显较低(p<0.05)。根据父母报告,仅自身免疫性肝炎患儿的身体和总分明显低于对照组(p<0.05)。进一步分析最近一个月有腹痛的自身免疫性肝炎患儿,发现身体、社会和总分中位数明显较低(p<0.05)。根据疾病缓解状态或疾病严重程度,未观察到差异(p>0.05)。在接受访谈时接受泼尼松剂量低于 0.16mg/kg/天的自身免疫性肝炎患儿的身体评分明显高于接受剂量相似或高于 0.16mg/kg/天的患儿(87.5[50-100]比 75[15.63-100],p=0.006)。

结论

与对照组相比,儿科自身免疫性肝炎患者在身体、情感和学校领域的评分较低。腹痛和皮质类固醇剂量对自身免疫性肝炎儿童和青少年的健康相关生活质量产生负面影响。

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