Zhang Hairui, Ren Ran, Liu Jinlin, Mao Ying, Pan Guowei, Men Ke, Ma Li
Institute for Research on Health Information and Technology, School of Public Health, Xi'an Medical University, Xi'an, Shaanxi 710021, China.
School of Public Health, Dalian Medical University, Dalian, Liaoning 116044, China.
Gastroenterol Res Pract. 2020 Jan 7;2020:6716103. doi: 10.1155/2020/6716103. eCollection 2020.
Patients with chronic liver disease (CLD) have extrahepatic manifestations and impaired health-related quality of life (HRQOL), and hepatitis C virus (HCV) infection is a leading cause of CLD, cirrhosis, and hepatocellular carcinoma (HCC). This study is aimed at assessing HRQOL in patients with HCV infection in the rural areas and identifying factors associated with impairment of HRQOL.
A cross-sectional study was conducted in a county of Liaoning Province in northeast China. HRQOL of patients with HCV infection was assessed using the chronic liver disease questionnaire (CLDQ) and EuroQol-5 dimensions (EQ-5D). Data were transformed to score comparisons of six major CLDQ domains, EQ index, and visual analog scale (VAS).
A total of 397 (93.4%) subjects, including 67 healthy subjects (HSs), 314 patients with chronic hepatitis C (CHC), and 16 patients with liver cirrhosis (LC) completed the study. The overall quartile CLDQ scores for HSs, patients with CHC, and patients with LC were 6.4 (6.0, 6.7), 5.8 (4.6, 6.4), and 4.1 (3.0, 6.0), respectively. The quartile scores of EQ index for the three groups were 1.0 (1.0, 1.0), 1.0 (0.8, 1.0), and 0.9 (0.6, 1.0), respectively. The median scores of EQ VAS for the three groups were 85.0, 60.0, and 60.0, respectively. Female sex, patients with family history of hepatitis, other comorbid chronic diseases, drinking, and disease duration ≥ 10 years were associated with significant improvement in overall CLDQ scores, and family history of hepatitis and other comorbid chronic diseases were considered predictive factors for EQ index and VAS, respectively.
Compared with HSs, HCV infection had a greater negative impact on HRQOL in patients with CHC and LC. The significant factors associated with HRQOL include female sex, patients with a family history of hepatitis, other comorbid chronic diseases, drinking, and disease duration ≥ 10 years. Patients with HCV infection in the rural areas should be paid careful attention regarding their HRQOL with proper health education and disease management.
慢性肝病(CLD)患者存在肝外表现且健康相关生活质量(HRQOL)受损,丙型肝炎病毒(HCV)感染是CLD、肝硬化和肝细胞癌(HCC)的主要病因。本研究旨在评估农村地区HCV感染患者的HRQOL,并确定与HRQOL受损相关的因素。
在中国东北辽宁省的一个县进行了一项横断面研究。使用慢性肝病问卷(CLDQ)和欧洲五维健康量表(EQ-5D)评估HCV感染患者的HRQOL。数据转换为CLDQ六个主要领域、EQ指数和视觉模拟量表(VAS)的得分比较。
共有397名(93.4%)受试者完成了研究,包括67名健康受试者(HSs)、314名慢性丙型肝炎(CHC)患者和16名肝硬化(LC)患者。HSs、CHC患者和LC患者的CLDQ总体四分位数得分分别为6.4(6.0,6.7)、5.8(4.6,6.4)和4.1(3.0,6.0)。三组的EQ指数四分位数得分分别为1.0(1.0,1.0)、1.0(0.8,1.0)和0.9(0.6,1.0)。三组的EQ VAS中位数得分分别为85.0、60.0和60.0。女性、有肝炎家族史的患者、其他合并慢性疾病、饮酒以及病程≥10年与CLDQ总体得分显著改善相关,肝炎家族史和其他合并慢性疾病分别被认为是EQ指数和VAS的预测因素。
与HSs相比,HCV感染对CHC和LC患者的HRQOL有更大的负面影响。与HRQOL相关的显著因素包括女性、有肝炎家族史的患者、其他合并慢性疾病、饮酒以及病程≥10年。农村地区的HCV感染患者的HRQOL应通过适当的健康教育和疾病管理予以密切关注。