Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan Society for the Promotion of Science, Tokyo.
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo.
Int J Tuberc Lung Dis. 2018 Jun 1;22(6):695-703. doi: 10.5588/ijtld.17.0433.
Little is known about the clinical characteristics and health-related quality of life (HQOL) of elderly patients with pulmonary Mycobacterium avium complex (pMAC) disease.
To evaluate HQOL using the 36-Item Short-Form Health Survey and St George's Respiratory Questionnaire (SGRQ) and to investigate the predictors of HQOL changes among elderly patients with pMAC disease.
This prospective cohort registry was conducted at Keio University Hospital, Tokyo, Japan, between May 2012 and July 2015 and included 84 patients with pMAC disease aged 75 years who had completed the HQOL questionnaire and 48 patients with pMAC disease who had been followed up and completed the HQOL questionnaire in cross-sectional and longitudinal analyses, respectively.
In cross-sectional analyses, elderly patients with pMAC disease had significantly lower role-physical, general health, vitality, social functioning, role-emotional and role/social component scores than the general Japanese elderly population. Analysis of covariance revealed that patients with cavitary lesions had significantly worse physical functioning and SGRQ scores (P < 0.05). Longitudinal analysis showed that under-treatment, short duration of disease and positive sputum smear at baseline were predictors of worse HQOL at 12 months.
Elderly patients with pMAC disease have reduced HQOL. Further large studies on HQOL are required to refine the use of this parameter in the treatment of these patients.
老年人肺部鸟分枝杆菌复合群(pMAC)病的临床特征和健康相关生活质量(HQOL)知之甚少。
使用 36 项简短健康调查和圣乔治呼吸问卷(SGRQ)评估 HQOL,并探讨影响 pMAC 病老年患者 HQOL 变化的预测因素。
这项前瞻性队列研究于 2012 年 5 月至 2015 年 7 月在日本东京庆应义塾大学医院进行,纳入了 84 名年龄≥75 岁且完成 HQOL 问卷的 pMAC 病患者和 48 名完成 HQOL 问卷的 pMAC 病患者,分别进行横断面和纵向分析。
在横断面分析中,pMAC 病老年患者的角色身体、一般健康、活力、社会功能、角色情感和角色/社会组成部分评分明显低于一般日本老年人群。协方差分析显示有空洞病变的患者生理功能和 SGRQ 评分明显更差(P<0.05)。纵向分析显示,治疗不足、疾病持续时间短和基线时痰涂片阳性是 12 个月时 HQOL 恶化的预测因素。
pMAC 病老年患者的 HQOL 降低。需要进一步开展关于 HQOL 的大型研究,以完善该参数在治疗此类患者中的应用。