Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
School of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Orphanet J Rare Dis. 2019 Aug 8;14(1):191. doi: 10.1186/s13023-019-1159-5.
Hereditary angioedema (HAE) is a rare but serious condition characterized by unpredictable and recurrent attacks affecting the skin and mucosa. HAE has wide-ranging impacts on the health-related quality of life (HRQoL) of patients. This study aims to assess the HRQoL of Chinese patients with HAE using the 36-item Short Form Health Survey (SF-36v2) and to explore potential risk factors for low HRQoL.
A total of 104 patients (47 male and 57 female) over age 18 living in China with a known diagnosis of HAE due to C1-INH deficiency completed the SF-36v2 (generic HRQoL questionnaire). The results were compared to Chinese population norms. Subgroup analysis and logistic regression were used to interpret the data.
SF-36v2 showed a significant reduction in all dimensions of HRQoL (p < 0.001) in patients with HAE compared with the general Chinese population. Female patients reported significantly lower bodily pain (BP) (p = 0.039) and physical component scores (PCSs) (p = 0.027) than male patients. Patients with mucosal edema tended to report lower role-physical (RP) limitations (p = 0.031) than patients with only skin edema. There were no differences between the mean scores of the SF-36 in relation to disease subtype, age, disease severity and long-term prophylaxis. Among female patients on long-term prophylaxis, social functioning (SF) (r = - 0.404, p = 0.010), role-emotional (RE) (r = - 0.320, p = 0.044) and mental component scores (MCSs) (r = - 0.313, p = 0.049) were negatively correlated with danazol dosage. A correlation between decreased disease control and decreased HRQoL scores was found, although the correlation was not significant in terms of RE or mental health (MH) scores. The logistic regression model revealed uncontrolled disease to be a risk factor for a low PCS (odds ratio 10.77, 95% confidence interval [CI] 1.78-65.06; p = 0.010) and laryngeal edema to be a risk factor for a low MCS (odds ratio 4.75, 95% CI 1.09-20.69; p = 0.038).
Chinese HAE patients reported significantly lower HRQoL scores than the general population. Unsatisfactory disease control is a risk factor for decreased PCSs. Laryngeal edema is a risk factor for decreased MCSs.
遗传性血管性水肿(HAE)是一种罕见但严重的疾病,其特征为皮肤和黏膜反复发作不可预测的肿胀。HAE 对患者的健康相关生活质量(HRQoL)有广泛影响。本研究旨在使用 36 项简短健康调查问卷(SF-36v2)评估中国 HAE 患者的 HRQoL,并探讨导致 HRQoL 较低的潜在危险因素。
共纳入 104 名年龄大于 18 岁的中国 HAE 患者(47 名男性和 57 名女性),这些患者均因 C1-INH 缺乏而确诊 HAE,他们完成了 SF-36v2(一般 HRQoL 调查问卷)。将结果与中国人群正常值进行比较。采用亚组分析和逻辑回归对数据进行解释。
与一般中国人群相比,HAE 患者的 SF-36v2 所有维度的 HRQoL 评分均显著降低(p<0.001)。女性患者报告的身体疼痛(BP)(p=0.039)和生理成分评分(PCS)(p=0.027)明显低于男性患者。有黏膜水肿的患者报告的角色-躯体限制(RP)明显低于仅有皮肤水肿的患者(p=0.031)。SF-36 评分与疾病亚型、年龄、疾病严重程度和长期预防治疗之间无差异。在接受长期预防治疗的女性患者中,社会功能(SF)(r=-0.404,p=0.010)、角色-情感(RE)(r=-0.320,p=0.044)和心理成分评分(MCSs)(r=-0.313,p=0.049)与丹那唑剂量呈负相关。虽然 RE 或心理健康(MH)评分的相关性无统计学意义,但发现疾病控制不佳与 HRQoL 评分降低之间存在相关性。逻辑回归模型显示,疾病未得到控制是 PCS 评分较低的危险因素(优势比 10.77,95%置信区间 [CI] 1.78-65.06;p=0.010),喉部水肿是 MCS 评分较低的危险因素(优势比 4.75,95% CI 1.09-20.69;p=0.038)。
中国 HAE 患者的 HRQoL 评分明显低于一般人群。疾病控制不理想是 PCS 评分降低的危险因素。喉部水肿是 MCS 评分降低的危险因素。