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直接作用抗病毒药物可改善丙型肝炎病毒患者的生活质量,减轻疾病相关症状,并在三年后增加肌肉量。

Direct-acting Antivirals Improved the Quality of Life, Ameliorated Disease-related Symptoms, and Augmented Muscle Volume Three Years Later in Patients with Hepatitis C Virus.

机构信息

Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan.

Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Japan.

出版信息

Intern Med. 2020;59(21):2653-2660. doi: 10.2169/internalmedicine.5102-20. Epub 2020 Nov 1.

Abstract

Objective Patient-reported outcomes (PROs) are important measures of the quality of life (QOL) and symptoms in patients with hepatitis C virus (HCV). We evaluated the PROs at the beginning of direct-acting antiviral (DAA) treatment and three years later. A low QOL in patients with chronic liver disease suggested a low muscle mass. We compared the relationship between the QOL and muscle mass. Methods DAAs were administered to 100 patients with HCV infection. The PROs included the cirrhosis-related symptom score (CSS), presence of restless legs syndrome, Pittsburg sleep quality index (PSQI) to evaluate sleep disturbance, SF-36 to measure the QOL, and calculated body muscle mass (CBMM) measured at the beginning of treatment and three years later. Computed tomography (CT) was used to screen 82 patients for hepatocellular carcinoma at the beginning of treatment and three years later. Cross-sectional CT images of the third lumbar vertebrae were analyzed to evaluate the body composition. Results The general health perception (GHN) of SF-36 was better at three years after DAA administration than at the beginning. Changes in the GHN (dGHN) were related to an improved sleep quality on the PSQI and CSS and increased CBMM. The dGHN was positively related to changes in the skeletal muscle. The sleep quality, sleep latency, fatigue, and abdominal fullness were related to dGHN. Conclusion The QOL is related to sleep disturbance and several other symptoms. Furthermore, in patients with an increased muscle volume after DAA treatment, increased muscle mass is associated with an improvement in the QOL.

摘要

目的

患者报告的结局(PROs)是评估丙型肝炎病毒(HCV)患者生活质量(QOL)和症状的重要指标。我们评估了直接作用抗病毒(DAA)治疗开始时和三年后的 PROs。慢性肝病患者的 QOL 较低表明肌肉量较低。我们比较了 QOL 和肌肉量之间的关系。方法:对 100 例 HCV 感染患者给予 DAA。PROs 包括肝硬化相关症状评分(CSS)、不安腿综合征的存在、匹兹堡睡眠质量指数(PSQI)评估睡眠障碍、SF-36 测量 QOL,并在治疗开始时和三年后测量身体肌肉质量(CBMM)。在治疗开始和三年后,使用计算机断层扫描(CT)筛查 82 例患者的肝细胞癌。分析第三腰椎的横断面 CT 图像以评估身体成分。结果:DAA 给药三年后,SF-36 的一般健康感知(GHN)比治疗开始时更好。GHN 的变化(dGHN)与 PSQI 和 CSS 睡眠质量的改善以及 CBMM 的增加有关。dGHN 与骨骼肌的变化呈正相关。睡眠质量、睡眠潜伏期、疲劳和腹胀与 dGHN 相关。结论:QOL 与睡眠障碍和其他几个症状有关。此外,在 DAA 治疗后肌肉体积增加的患者中,肌肉量的增加与 QOL 的改善相关。

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