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肝移植对原发性胆汁性胆管炎患者健康相关生活质量的影响。

Effects of liver transplantation on health-related quality of life in patients with primary biliary cholangitis.

机构信息

Department of Medicine II, Saarland University Medical Center, Homburg, Germany.

Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.

出版信息

Clin Transplant. 2018 Dec;32(12):e13434. doi: 10.1111/ctr.13434. Epub 2018 Dec 6.

DOI:10.1111/ctr.13434
PMID:30362634
Abstract

BACKGROUND

Patients with primary biliary cholangitis (PBC) have decreased health-related quality of life (HRQoL). Here, we investigate HRQoL in two cohorts of transplanted patients with PBC and compare their results to healthy subjects.

PATIENTS AND METHODS

We used generic SF-36 and disease-specific PBC-40 questionnaires to evaluate HRQoL in 26 patients with PBC (23 females, age 59.4 ± 5.7 years) before and after liver transplantation (LT), and in 107 patients with PBC (99 females, age 62.8 ± 6.7 years) who were previously transplanted. The control group was comprised of 60 healthy controls (55 females, age 54.6 ± 8.8 years).

RESULTS

Health-related quality of life improved after LT in 85% of PBC patients. The SF-36 measure showed significant (all P < 0.05) improvements in the majority of domains after LT, and in the summary scores both physical and mental. We also documented significant improvements in pruritus and fatigue after LT (all P < 0.01). However, liver graft recipients had significantly worse physical functioning, physical role, and emotional role domains, and physical component score (all P < 0.001), as compared to healthy subjects. No differences in HRQoL were detected between patients evaluated after short and prolonged post-LT periods (P > 0.05).

CONCLUSION

Liver transplantation substantially improves most aspects of life quality in PBC patients. Nevertheless, their HRQoL remains worse in comparison to healthy individuals, mainly in physical aspects.

摘要

背景

原发性胆汁性胆管炎 (PBC) 患者的健康相关生活质量 (HRQoL) 下降。在此,我们调查了两批接受 PBC 肝移植的患者的 HRQoL,并将其结果与健康受试者进行比较。

患者和方法

我们使用通用 SF-36 和疾病特异性 PBC-40 问卷,在肝移植 (LT) 前和后评估 26 名 PBC 患者 (23 名女性,年龄 59.4 ± 5.7 岁) 的 HRQoL,并评估 107 名之前接受过肝移植的 PBC 患者 (99 名女性,年龄 62.8 ± 6.7 岁)。对照组由 60 名健康对照者组成 (55 名女性,年龄 54.6 ± 8.8 岁)。

结果

85%的 PBC 患者在 LT 后 HRQoL 得到改善。SF-36 测量结果显示,LT 后大多数领域的评分均有显著改善 (均 P < 0.05),且身体和心理综合评分也有所改善。我们还记录到 LT 后瘙痒和疲劳显著改善 (均 P < 0.01)。然而,与健康受试者相比,肝移植物受者的身体机能、身体角色和情绪角色以及身体成分评分明显较差 (均 P < 0.001)。在 LT 后短期和长期评估的患者之间,HRQoL 没有差异 (P > 0.05)。

结论

肝移植可显著改善 PBC 患者的大多数生活质量方面。然而,与健康个体相比,他们的 HRQoL 仍然较差,主要在身体方面。

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