盐皮质激素受体拮抗剂对原发性醛固酮增多症患者生活质量的影响
Quality of Life of Primary Aldosteronism Patients by Mineralocorticoid Receptor Antagonists.
作者信息
Yoshida Yuichi, Yoshida Rika, Shibuta Kanako, Ozeki Yoshinori, Okamoto Mitsuhiro, Gotoh Koro, Masaki Takayuki, Shibata Hirotaka
机构信息
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Oita, Japan.
Faculty of Medicine, Oita University, Oita, Japan.
出版信息
J Endocr Soc. 2021 Feb 16;5(4):bvab020. doi: 10.1210/jendso/bvab020. eCollection 2021 Apr 1.
CONTEXT
Although primary aldosteronism (PA) reduces quality of life (QOL), there have been no reports on whether treatment with a mineralocorticoid receptor antagonist (MRA) improves QOL in Japanese PA patients.
OBJECTIVE
Using the 36-Item Short-Form Health Survey (SF-36), we compared the QOL of PA patients before and after treatment and evaluated whether the effectiveness of MRAs differs by sex and serum potassium level.
METHODS
In 50 patients diagnosed with PA (with or without hypokalemia) and treated with an MRA, the SF-36 scores, blood pressure, and clinical features were assessed before, and 3 and 6 months after treatment. Separate analyses were also conducted for males and females.
RESULTS
The normative mean SF-36 score of the healthy subjects was 50. The pretreatment Role-Physical (RP) (46.7 ± 1.8, = .019), General Health (47.1 ± 1.3, = .042), and Role-Emotional (47.2 ± 1.7, = .045) SF-36 subscale scores of all PA patients were significantly lower than those of healthy subjects but were improved by MRA treatment. Females with PA had a lower RP score (45.1 ± 2.2, = .008), which was not improved by MRA treatment (46.1 ± 2.4, = .036). In addition, PA patients with hypokalemia had a lower Mental Health SF-36 subscale score (43.2 ± 4.4, = .041), which was improved by treatment with an MRA.
CONCLUSION
MRAs improved the QOL of Japanese PA patients, but female PA patients may be more resistant to MRAs.
背景
尽管原发性醛固酮增多症（PA）会降低生活质量（QOL），但尚无关于盐皮质激素受体拮抗剂（MRA）治疗是否能改善日本PA患者生活质量的报道。
目的
使用36项简明健康调查（SF-36），我们比较了PA患者治疗前后的生活质量，并评估MRA的有效性是否因性别和血清钾水平而异。
方法
对50例诊断为PA（有或无低钾血症）并接受MRA治疗的患者，在治疗前、治疗后3个月和6个月评估SF-36评分、血压和临床特征。还对男性和女性进行了单独分析。
结果
健康受试者的标准化平均SF-36评分为50。所有PA患者治疗前的角色-身体（RP）（46.7±1.8，P = 0.019）、总体健康（47.1±1.3，P = 0.042）和角色-情感（47.2±1.7，P = 0.045）SF-36子量表评分均显著低于健康受试者，但经MRA治疗后有所改善。患有PA的女性RP评分较低（45.1±2.2，P = 0.008），经MRA治疗后未改善（46.1±2.4，P = 0.036）。此外，患有低钾血症的PA患者心理健康SF-36子量表评分较低（43.2±4.4，P = 0.041），经MRA治疗后有所改善。
结论
MRA改善了日本PA患者的生活质量，但女性PA患者可能对MRA更具耐药性。
Zotero 插件