Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Department of Gastroenterology and Hepatology, Nara Medical University School of Medicine, Kashihara, Nara, Japan.
PLoS One. 2018 Oct 4;13(10):e0204772. doi: 10.1371/journal.pone.0204772. eCollection 2018.
Health-related quality of life is impaired in patients with autoimmune hepatitis, but the association between health-related quality of life and patients' backgrounds remains unknown. We assessed health-related quality of life in patients with autoimmune hepatitis and identified factors associated with its impairment.
We assessed health-related quality of life in patients with autoimmune hepatitis, patients with chronic hepatitis C, and healthy subjects using the Japanese version of the Chronic Liver Disease Questionnaire and the 36-Item Short Form Survey. We compared health-related quality of life in patients with autoimmune hepatitis with that of patients with chronic hepatitis C and healthy subjects.
A total of 265 patients with autoimmune hepatitis, 88 patients with chronic hepatitis C, and 97 healthy subjects were enrolled; most patients were women. The median ages of patients were 65, 66, and 57 years, respectively. Of these patients with autoimmune hepatitis, 10.6% and 57.0% had cirrhosis and comorbid diseases, respectively. The overall Chronic Liver Disease Questionnaire scores (5.5 vs. 6.2, P < 0.001) and physical (48.1 vs. 54.2, P < 0.001) and mental (51.8 vs. 55.0, P = 0.004) component summaries of 36-Item Short Form Survey were significantly lower in patients with autoimmune hepatitis than in healthy subjects, and similar to scores in patients with chronic hepatitis C. Having cirrhosis, comorbid diseases, and treatment for autoimmune hepatitis were associated with impaired health-related quality of life among patients with autoimmune hepatitis. In particular, prednisolone use was associated with lower scores on the worry domain of the Chronic Liver Disease Questionnaire.
Patients with autoimmune hepatitis showed impairment in health-related quality of life, which was associated with not only disease progression, but also comorbid diseases and treatment. Ways to improve health-related quality of life should be considered in patients with AIH when disease outcome is not favorable and when using prednisolone.
自身免疫性肝炎患者的健康相关生活质量受损，但健康相关生活质量与患者背景之间的关系尚不清楚。我们评估了自身免疫性肝炎患者的健康相关生活质量，并确定了与其受损相关的因素。
我们使用日本版慢性肝脏疾病问卷和 36 项简短健康调查问卷评估了自身免疫性肝炎患者、慢性丙型肝炎患者和健康受试者的健康相关生活质量。我们比较了自身免疫性肝炎患者的健康相关生活质量与慢性丙型肝炎患者和健康受试者的健康相关生活质量。
共纳入 265 例自身免疫性肝炎患者、88 例慢性丙型肝炎患者和 97 例健康受试者；大多数患者为女性。患者的中位年龄分别为 65、66 和 57 岁。其中，10.6%和 57.0%的自身免疫性肝炎患者分别患有肝硬化和合并症。总体慢性肝脏疾病问卷评分（5.5 分比 6.2 分，P < 0.001）和 36 项简短健康调查问卷的身体（48.1 分比 54.2 分，P < 0.001）和精神（51.8 分比 55.0 分，P = 0.004）成分摘要在自身免疫性肝炎患者中明显低于健康受试者，与慢性丙型肝炎患者相似。患有肝硬化、合并症和自身免疫性肝炎治疗与自身免疫性肝炎患者的健康相关生活质量受损相关。特别是，泼尼松龙的使用与慢性肝脏疾病问卷的担忧领域得分较低相关。
自身免疫性肝炎患者的健康相关生活质量受损，这不仅与疾病进展有关，还与合并症和治疗有关。在疾病结局不佳和使用泼尼松龙时，应考虑改善 AIH 患者的健康相关生活质量。
