病毒学参数和肝纤维化对非洲黑人慢性乙型肝炎患者健康相关生活质量的影响：高流行地区的研究结果
The Impact of Virologic Parameters and Liver Fibrosis on Health-Related Quality of Life in Black African Patients with Chronic Hepatitis B: Results from a High Endemic Area.
作者信息
Mahassadi Alassan Kouamé, Team Machekam Olga, Attia Alain Koffi
机构信息
Hepatology and Gastroenterology Unit, Yopougon Teaching Hospital, Abidjan, Côte d'Ivoire.
Faculty of Medicine, Department of Gastrointestinal Diseases, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire.
出版信息
Clin Exp Gastroenterol. 2020 Oct 2;13:407-418. doi: 10.2147/CEG.S255102. eCollection 2020.
BACKGROUND
The effects of virologic parameters, liver fibrosis, and treatment on the HRQoL in black African patients with CHB are unknown.
OBJECTIVE
To determine the magnitude and the effects of hepatitis B e antigen (HBeAg), hepatitis B surface antigenemia (HBs antigenemia), viral load, liver fibrosis and treatment on HRQoL impairment in black African patients with CHB using the SF36 (SF36) and chronic liver disease questionnaires (CLDQ).
MATERIALS AND METHODS
HRQoL comparison was determined in a case-control study and enrolled 214 patients with CHB (mean age: 42 years, male: 65.9%) and 210 healthy controls subjects (mean age: 37.8 years; male: 63.8%). Control subjects were younger than those with CHB (p=0.01). Analysis of covariance, Welch test and linear regression were used to compare HRQoL between subgroups.
RESULTS
Adjusted to age and gender, patients with CHB elicited low mean scores on the subscales of role-physical (66.9 vs 78, p=0.001), role-emotional (64 vs 77.5, p=0.01), bodily pain (70.8 vs 96.2, p=0.001), social functioning (74.6 vs 84.5, p=0.003) and general health (64.6 vs 74.4, p=0.03) in comparison with control subjects. Multivariate analysis showed that CHB impaired HRQoL on physical (β= -16.7 (1.8), p<0.0001) and mental component summaries (β= -5.1 (2.0), p=0.01) adjusted to others variables. Patients with HBeAg negative CHB elicited low scores on physical (p=0.004) and mental (p=0.05) component summaries and low CLDQ's average score (p=0.002) in comparison with those positive. Patients with low (≤1000 IU/mL) HBs antigenemia (p=0.03) or viral load (p=0.03) scored less on physical component summary and those with significant fibrosis or cirrhosis scored less (p=0.003) on mental component summary.
CONCLUSION
Black African patients with CHB expressed poor HRQoL, particularly those with HBeAg negative CHB, low viral load, or HBs Antigenemia.
背景
在非洲黑人慢性乙型肝炎（CHB）患者中，病毒学参数、肝纤维化及治疗对健康相关生活质量（HRQoL）的影响尚不清楚。
目的
使用SF-36健康调查简表（SF36）和慢性肝病问卷（CLDQ），确定乙肝e抗原（HBeAg）、乙肝表面抗原血症（HBs抗原血症）、病毒载量、肝纤维化及治疗对非洲黑人CHB患者HRQoL损害的程度及影响。
材料与方法
在一项病例对照研究中对HRQoL进行比较，纳入214例CHB患者（平均年龄：42岁，男性：65.9%）和210例健康对照者（平均年龄：37.8岁；男性：63.8%）。对照者比CHB患者年轻（p = 0.01）。采用协方差分析、韦尔奇检验和线性回归比较亚组间的HRQoL。
结果
校正年龄和性别后，与对照者相比，CHB患者在生理功能（66.9对78，p = 0.001）、情感职能（64对77.5，p = 0.01）、躯体疼痛（70.8对96.2，p = 0.001）、社会功能（74.6对84.5，p = 0.003）和总体健康（64.6对74.4，p = 0.03）等分量表上的平均得分较低。多变量分析显示，校正其他变量后，CHB在生理（β = -16.7(1.8)，p < 0.0001）和心理综合评分（β = -5.1(2.0)，p = 0.01）方面损害了HRQoL。与HBeAg阳性的CHB患者相比，HBeAg阴性的CHB患者在生理（p = 0.004）和心理（p = 0.05）综合评分以及CLDQ平均得分（p = 0.002）方面得分较低。低水平（≤1000 IU/mL）HBs抗原血症（p = 0.03）或病毒载量（p = 0.03）的患者在生理综合评分上得分较低，而有显著纤维化或肝硬化的患者在心理综合评分上得分较低（p = 0.003）。
结论
非洲黑人CHB患者的HRQoL较差，尤其是那些HBeAg阴性、病毒载量低或有HBs抗原血症的患者。
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