Yorke Janelle, Deaton Christi, Campbell Malcolm, McGowen Linda, Sephton Paul, Kiely David G, Armstrong Iain
Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK.
Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK.
BMJ Open Respir Res. 2018 Mar 1;5(1):e000263. doi: 10.1136/bmjresp-2017-000263. eCollection 2018.
The aim of this cohort study was to examine health-related quality of life (HRQoL) and symptomatology in patients with pulmonary hypertension (PH) and explore factors that influence its evolution over time.
A prospective longitudinal multisite cohort study. Participants were recruited from specialist UK PH centres and completed a questionnaire pack at baseline, 6, 12 and 18 months to assess HRQoL (emPHasis-10), dyspnoea, fatigue, sleep, anxiety and depression.
185 patients entered the study at baseline and 126 (68%) completed month 18. At baseline, patients had significant impairment of HRQoL, anxiety, depression, dyspnoea and severe fatigue. No significant changes, apart from a reduction in the Hospital Anxiety and Depression Scale-Anxiety score (P=0.04), were observed over 18 months. Depression and dyspnoea were predictors of HRQoL (P=0.002 and P=0.03, respectively). Oxygen use was also associated with diminished HRQoL and increased symptom severity.
Patients with PH experience high levels of symptom severity and the negative impact on HRQoL was unchanged over time. The use of oxygen therapy, in particular, was associated with a significant impact on HRQoL. Further study of factors impacting HRQoL and interventions that target a combination of physiological and psychosocial consequences of living with PH are needed.
本队列研究的目的是检查肺动脉高压（PH）患者的健康相关生活质量（HRQoL）和症状，并探索影响其随时间演变的因素。
一项前瞻性纵向多中心队列研究。参与者从英国的专科肺动脉高压中心招募，并在基线、6个月、12个月和18个月时完成一套问卷，以评估健康相关生活质量（emPHasis-10）、呼吸困难、疲劳、睡眠、焦虑和抑郁情况。
185名患者在基线时进入研究，126名（68%）完成了18个月的随访。基线时，患者的健康相关生活质量、焦虑、抑郁、呼吸困难和严重疲劳均有显著损害。在18个月期间，除医院焦虑抑郁量表-焦虑评分有所降低（P=0.04）外，未观察到其他显著变化。抑郁和呼吸困难是健康相关生活质量的预测因素（分别为P=0.002和P=0.03）。吸氧也与健康相关生活质量下降以及症状严重程度增加有关。
肺动脉高压患者症状严重程度较高，且对健康相关生活质量的负面影响随时间未发生变化。特别是吸氧治疗对健康相关生活质量有显著影响。需要进一步研究影响健康相关生活质量的因素以及针对肺动脉高压患者生理和心理社会综合后果的干预措施。
