Tamada Naoki, Nakayama Kazuhiko, Yanaka Kenichi, Onishi Hiroyuki, Shinkura Yuto, Taniguchi Yu, Kinutani Hiroto, Tsuboi Yasunori, Izawa Kazuhiro P, Satomi-Kobayashi Seimi, Otake Hiromasa, Tanaka Hiroshi, Shinke Toshiro, Okita Yutaka, Emoto Noriaki, Hirata Ken-Ichi
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine Kobe Japan.
Division of Cardiology, Department of Internal Medicine, Shinko Hospital Kobe Japan.
Circ Rep. 2019 Apr 18;1(5):228-234. doi: 10.1253/circrep.CR-19-0016.
While hemodynamics and exercise capacity in patients with chronic thromboembolic pulmonary hypertension (CTEPH) can be improved by invasive therapy such as pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA), there has been little data on the health-related quality of life (HRQOL) in such patients. This single-center and observational study compared the impact of invasive therapy on HRQOL. We utilized the Medical Outcome Study 36-Item Short Health Survey (SF-36) to measure HRQOL and compared HRQOL changes after PEA and BPA. A total of 48 patients were diagnosed with CTEPH. Of these, 39 patients completed questionnaires before and after invasive therapy. The PEA group (n=15) and the BPA group (n=24) had similar improvements in clinical parameters. With regard to HRQOL score, both groups had fairly low scores in physical functioning (PF), role physical (RP), general health (GH), social functioning (SF), role emotional (RE), and physical component summary (PCS) at baseline. PF, GH, vitality (VT), mental health (MH), and PCS had significant improvements in the PEA group while PCS and all subscales except for bodily pain (BP) had significant improvements in the BPA group. Furthermore, changes between baseline and follow-up were not significantly different between the 2 groups. BPA for patients who are ineligible for PEA can recover HRQOL to a similar level to that achieved by PEA.
虽然慢性血栓栓塞性肺动脉高压(CTEPH)患者的血流动力学和运动能力可通过诸如肺动脉内膜剥脱术(PEA)和球囊肺动脉血管成形术(BPA)等侵入性治疗得到改善,但关于此类患者与健康相关的生活质量(HRQOL)的数据却很少。这项单中心观察性研究比较了侵入性治疗对HRQOL的影响。我们使用医学结局研究36项简短健康调查问卷(SF - 36)来测量HRQOL,并比较了PEA和BPA术后HRQOL的变化。共有48例患者被诊断为CTEPH。其中,39例患者在侵入性治疗前后完成了问卷调查。PEA组(n = 15)和BPA组(n = 24)在临床参数方面有相似的改善。关于HRQOL评分,两组在基线时身体功能(PF)、角色身体(RP)、总体健康(GH)、社会功能(SF)、角色情感(RE)和身体成分总结(PCS)方面的得分都相当低。PEA组的PF、GH活力(VT)、心理健康(MH)和PCS有显著改善,而BPA组的PCS以及除身体疼痛(BP)外的所有子量表都有显著改善。此外,两组在基线和随访之间的变化没有显著差异。对于不符合PEA条件的患者,BPA可使HRQOL恢复到与PEA相似的水平。