德国莱比锡遗传性血管性水肿患者预防性治疗与焦虑降低相关。
Prophylactic Treatment in Hereditary Angioedema Is Associated with Reduced Anxiety in Patients in Leipzig, Germany.
机构信息
Department of Dermatology, Venereology and Allergology, University Hospital Leipzig, Leipzig, Germany.
出版信息
Int Arch Allergy Immunol. 2021;182(9):819-826. doi: 10.1159/000514973. Epub 2021 Apr 22.
BACKGROUND
Hereditary angioedema (HAE) is associated with relevant disease-related burden. We aimed at investigating prevalence of depression and anxiety in patients with HAE in Leipzig, Germany.
METHODS
Questionnaire-based evaluation of medical history, Angioedema Control Test (AECT), Angioedema Quality of Life Questionnaire (AE-QoL), Generalized Anxiety Disorder Scale-7 (GAD-7), and Hospital Anxiety and Depression Scale (HADS).
RESULTS
Thirty-seven patients with HAE were included (31 females, mean age 49.6 ± 17.5 years). A mean diagnostic delay between first symptoms and correct diagnosis of 14.2 ± 14.5 years was detected. Patients aged <50 years (n = 18) had been diagnosed significantly earlier with HAE than older patients (p = <0.001). In 6 patients (16.2%), unnecessary medical interventions were performed and 14 patients (43.8%) reported at least 1 HAE-related death of a family member. Psychological stress was the most common triggering factor (96.2%). HADS scores revealed depression in 5/37 patients (13.5%) and anxiety in 16/37 (43.2%), GAD-7 score indicated anxiety in 9/36 (25%) participants. Patients receiving long-term prophylactic treatment (n = 17, 45.9%) showed significantly better disease control (AECT; p = <0.001) and quality of life (AE-QoL; p = <0.001) compared to those with on-demand treatment only. Patients with long-term prophylactic treatment showed significantly lower scores for anxiety and depression at GAD-7 (p = 0.011) and HADS (anxiety: p = 0.021; depression: p = 0.008). In 5 patients, treatment regime was changed as AECT score indicated insufficient disease control. Subsequently, we measured significant improvement of quality of life (AE-QoL, p = 0.04) and disease control (AECT; p = 0.032).
CONCLUSION
Anxiety was a frequent burden in our study group and showed a significant association with low disease control. Our data indicate that prophylactic HAE treatment can improve psychosocial burden of HAE.
背景
遗传性血管性水肿（HAE）与相关疾病负担有关。我们旨在研究德国莱比锡 HAE 患者的抑郁和焦虑患病率。
方法
基于问卷的病史评估、血管性水肿控制测试（AECT）、血管性水肿生活质量问卷（AE-QoL）、广泛性焦虑症量表-7（GAD-7）和医院焦虑和抑郁量表（HADS）。
结果
纳入 37 例 HAE 患者（31 名女性，平均年龄 49.6 ± 17.5 岁）。检测到从首次出现症状到正确诊断的平均诊断延迟为 14.2 ± 14.5 年。年龄<50 岁的患者（n = 18）比年龄较大的患者更早被诊断为 HAE（p<0.001）。6 名患者（16.2%）接受了不必要的医疗干预，14 名患者（43.8%）报告至少有 1 名亲属因 HAE 相关死亡。心理压力是最常见的触发因素（96.2%）。HADS 评分显示 5/37 例患者（13.5%）有抑郁，16/37 例患者（43.2%）有焦虑，GAD-7 评分显示 9/36 例患者（25%）有焦虑。接受长期预防性治疗的患者（n = 17，45.9%）在 AECT（p<0.001）和 AE-QoL（p<0.001）方面显示出显著更好的疾病控制，与仅按需治疗的患者相比。接受长期预防性治疗的患者在 GAD-7 （p = 0.011）和 HADS（焦虑：p = 0.021；抑郁：p = 0.008）的焦虑和抑郁评分明显较低。在 5 名患者中，由于 AECT 评分表明疾病控制不足，治疗方案发生了变化。随后，我们测量到生活质量（AE-QoL，p = 0.04）和疾病控制（AECT；p = 0.032）的显著改善。
结论
焦虑是我们研究组的一个常见负担，与疾病控制不佳有显著关联。我们的数据表明，预防性 HAE 治疗可以改善 HAE 的社会心理负担。
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