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先天性心脏病治疗对生活质量的影响。

Effects of Congenital Heart Disease Treatmenton Quality of Life.

机构信息

Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technical University of Munich, Munich, Germany; University of Texas MD Anderson Cancer Center, Houston, Texas.

Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technical University of Munich, Munich, Germany; Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.

出版信息

Am J Cardiol. 2019 Apr 1;123(7):1163-1168. doi: 10.1016/j.amjcard.2018.12.048. Epub 2019 Jan 8.

Abstract

With rising survival rates of patients with congenital heart disease (CHD), functional health variables have become the key aspect in treatment evaluation. The effectiveness of various treatment options on the health-related quality of life (HRQoL) and the objectively measured exercise capacity as peak oxygen uptake (VO peak) remains rather unclear and hence, its investigation is the primary aim of this study. Data from 1014 patients (≥14-years-old, various CHD) were retrospectively reviewed. The patients had completed at least twice the SF-36 questionnaire on HRQoL prior to a cardiopulmonary exercise test. Each patient was assigned to 1 of 4 treatment groups (i.e., surgery, catheter intervention, drug therapy, and surveillance) according to the received treatment between the baseline and the follow-up examination. After 4.0 ± 2.2 years of follow-up, patients with surgery and catheter intervention showed an increase in the physical summary score of HRQoL as compared to the other treatment groups (p <0.001). This effect remained also significant in a multivariable model accounting for anthropometric and baseline data. No significant differences in the mental summary score of HRQoL and the VO peak were evident between the different treatment groups in the multivariable model. No significant correlation was found between the changes in HRQoL and VO peak over time. In conclusion, despite insignificant changes in aerobic capacity, adolescents and adults with CHD report better physical HRQoL following surgery and catheter intervention compared to the other treatment options. HRQoL and exercise capacity need to be considered concurrently in the evaluation of adolescents and adults with CHD.

摘要

随着先天性心脏病(CHD)患者存活率的提高,功能健康变量已成为治疗评估的关键方面。各种治疗选择对健康相关生活质量(HRQoL)和客观测量的运动能力(最大摄氧量 VOpeak)的影响仍不清楚,因此,本研究旨在对此进行调查。回顾性分析了 1014 名(≥14 岁,各种 CHD)患者的数据。这些患者在心肺运动测试前至少完成了两次 SF-36 问卷,以评估 HRQoL。根据基线和随访检查之间接受的治疗,每位患者被分配到 4 个治疗组之一(即手术、导管介入、药物治疗和监测)。在 4.0±2.2 年的随访后,与其他治疗组相比,接受手术和导管介入治疗的患者 HRQoL 的身体综合评分有所增加(p<0.001)。在考虑了人体测量学和基线数据的多变量模型中,这种影响仍然显著。在多变量模型中,不同治疗组之间的 HRQoL 心理综合评分和 VOpeak 无显著差异。HRQoL 和 VOpeak 的变化之间没有发现明显的相关性。总之,尽管有氧运动能力没有明显变化,但与其他治疗选择相比,患有 CHD 的青少年和成年人报告手术后和导管介入治疗后身体 HRQoL 更好。在评估患有 CHD 的青少年和成年人时,需要同时考虑 HRQoL 和运动能力。

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