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非晚期肥大细胞增多症成人的健康相关生活质量及其影响因素:一项横断面研究和定性方法。

Health-Related Quality of Life and Influencing Factors in Adults with Nonadvanced Mastocytosis-A Cross-Sectional Study and Qualitative Approach.

机构信息

Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany.

Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany.

出版信息

J Allergy Clin Immunol Pract. 2021 Aug;9(8):3166-3175.e2. doi: 10.1016/j.jaip.2021.04.059. Epub 2021 May 26.

DOI:10.1016/j.jaip.2021.04.059
PMID:33965596
Abstract

BACKGROUND

Mastocytosis comprises a heterogeneous group of disorders characterized by an accumulation of mast cells in 1 or more organs. Symptoms range from mild complaints to severe and life-threatening events. Impact on quality of life seems to vary widely, but influencing factors are poorly understood so far.

OBJECTIVE

To examine impairments, psychological burden, health-related quality of life (HRQOL), and possible influencing factors in patients with mastocytosis.

METHODS

In semistructured telephone interviews, patients provided information on impairments in everyday life and psychological burden caused by mastocytosis. HRQOL was measured using the Mastocytosis Quality of Life (MC-QoL) questionnaire. Clinical data were collected from patient files.

RESULTS

A total of 101 adult patients with mastocytosis (74.3% women; mean age, 47.7 ± 13.5 years) were included. Half of the interviewed patients (50.6%) reported disease-related impairments in everyday life, and 42.4% stated a psychological burden. MC-QoL questionnaire scores showed a broad distribution, with a mean total score at a "mild" impairment level (mean total score, 34.7 ± 22.5). One-third of patients felt moderately (22.8%) or severely (13.9%) impaired, whereas one-third reported no impairment at all (30.7%). Symptoms of mast cell activation and perceived food intolerance had the highest impact on HRQOL. Higher age, higher body mass index, higher tryptase level, and longer duration of symptoms, as well as current drug therapy and pathological bone density, were each associated with reduced HRQOL.

CONCLUSIONS

A high level of suffering and strong associations between impairments and symptom-related factors indicate the importance of addressing patients' concerns and adequate symptom management in mastocytosis.

摘要

背景

肥大细胞增多症包括一组以 1 个或多个器官中肥大细胞积累为特征的异质性疾病。症状范围从轻度不适到严重和危及生命的事件。生活质量的影响似乎差异很大,但迄今为止影响因素了解甚少。

目的

检查肥大细胞增多症患者的障碍、心理负担、健康相关生活质量(HRQOL)以及可能的影响因素。

方法

在半结构化电话访谈中,患者提供了有关因肥大细胞增多症导致日常生活障碍和心理负担的信息。使用肥大细胞增多症生活质量(MC-QoL)问卷测量 HRQOL。从患者档案中收集临床数据。

结果

共纳入 101 例成年肥大细胞增多症患者(74.3%为女性;平均年龄 47.7 ± 13.5 岁)。接受采访的患者中有一半(50.6%)报告疾病相关的日常生活障碍,42.4%表示存在心理负担。MC-QoL 问卷评分分布广泛,平均总分处于“轻度”损伤水平(平均总分 34.7 ± 22.5)。三分之一的患者感觉中度(22.8%)或重度(13.9%)受损,而三分之一的患者根本没有受损(30.7%)。肥大细胞激活症状和感知的食物不耐受对 HRQOL 的影响最大。较高的年龄、较高的体重指数、较高的类胰蛋白酶水平、较长的症状持续时间,以及当前的药物治疗和病理性骨密度,均与 HRQOL 降低相关。

结论

较高的痛苦水平和障碍与症状相关因素之间的强烈关联表明,在肥大细胞增多症中,解决患者的担忧和适当的症状管理非常重要。

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