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手术治疗的肢端肥大症患者,无论通过手术控制还是需要额外的药物治疗,其生活质量都相似(QuaLAT 研究)。

Surgically treated acromegaly patients have a similar quality of life whether controlled by surgery or requiring additional medical therapy (QuaLAT Study).

机构信息

Department of Endocrinology and Diabetes, Sheffield Teaching Hospitals, Glossop Road, Sheffield, S10 2 JF, UK.

Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.

出版信息

Pituitary. 2021 Oct;24(5):768-777. doi: 10.1007/s11102-021-01153-4. Epub 2021 May 12.

DOI:10.1007/s11102-021-01153-4
PMID:33982222
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8416856/
Abstract

PURPOSE

There is no consensus on quality of life (QOL) in patients with acromegaly requiring medical treatment after surgery compared with those achieving remission by surgery alone.

METHODS

QuaLAT is a cross-sectional study comparing QOL in surgery-only treated acromegaly patients versus those requiring medical treatment post-surgery. Patients attending clinics were identified and divided into-Group 1: patients who had surgery only and were in biochemical remission, Group 2: all patients on medical treatment post-surgery, Group 3: patients from Group 2 with biochemical control. Participants were asked to fill three questionnaires; Acromegaly Quality of Life Questionnaire (ACROQOL), 36-Item Short Form Survey (SF36), and Fatigue Severity Scale (FSS).

RESULTS

There were 32 patients in Group 1 and 25 in Group 2. There was no difference in QOL scores between groups 1 and 2, as measured by ACROQOL (mean difference [MD] = - 2.5, 95% CI - 16.6 to 11.6; p = 0.72), SF36v2 [Physical component score (PCS) MD = - 4.9, 95% CI - 10.9 to 1.2; p = 0.12; mental component score MD = - 3.0, 95% CI - 10.5 to 4.4; p = 0.44], or FSS (MD = - 0.004, 95% CI - 1.14 to 1.33; p = 0.1). Comparison between groups 1 and 3 however showed that PCS (and 3 subdomains) was significantly better in group 3 (MD = - 8.3, 95% CI - 14.8 to -1.8; p = 0.01). All three QOL scores were lower when compared with healthy controls.

CONCLUSIONS

Medical treatment not only achieves a QOL comparable to surgery, it may also be associated with better QOL in physical subdomains. When compared with healthy controls, QOL remains worse in treated acromegaly patients compared to controls.

摘要

目的

与单独手术即可缓解疾病的肢端肥大症患者相比,术后需要接受药物治疗的患者的生活质量(QOL)尚未达成共识。

方法

QuaLAT 是一项横断面研究,比较了仅接受手术治疗的肢端肥大症患者与术后需要药物治疗的患者的 QOL。通过诊所识别患者,并将其分为三组:第 1 组:仅接受手术且生化缓解的患者;第 2 组:所有术后接受药物治疗的患者;第 3 组:第 2 组中生化控制的患者。要求参与者填写三个问卷:肢端肥大症生活质量问卷(ACROQOL)、36 项简短健康调查问卷(SF36v2)和疲劳严重程度量表(FSS)。

结果

第 1 组有 32 名患者,第 2 组有 25 名患者。第 1 组和第 2 组之间的 QOL 评分没有差异,ACROQOL(平均差异 [MD] = -2.5,95%置信区间 [CI] -16.6 至 11.6;p = 0.72)、SF36v2[物理成分评分(PCS)MD = -4.9,95%CI -10.9 至 1.2;p = 0.12;精神成分评分 MD = -3.0,95%CI -10.5 至 4.4;p = 0.44]或 FSS(MD = -0.004,95%CI -1.14 至 1.33;p = 0.1)。然而,第 1 组与第 3 组之间的比较表明,第 3 组的 PCS(和 3 个亚域)明显更好(MD = -8.3,95%CI -14.8 至 -1.8;p = 0.01)。与健康对照组相比,所有三种 QOL 评分均较低。

结论

药物治疗不仅可以达到与手术相当的 QOL,而且可能与生理亚领域的更好 QOL 相关。与健康对照组相比,接受治疗的肢端肥大症患者的 QOL 仍然较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b8e/8416856/549f4e5f88d7/11102_2021_1153_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b8e/8416856/0cc136b2d399/11102_2021_1153_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b8e/8416856/daf0c42d1b2a/11102_2021_1153_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b8e/8416856/8e45641a0804/11102_2021_1153_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b8e/8416856/549f4e5f88d7/11102_2021_1153_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b8e/8416856/0cc136b2d399/11102_2021_1153_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b8e/8416856/daf0c42d1b2a/11102_2021_1153_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b8e/8416856/8e45641a0804/11102_2021_1153_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b8e/8416856/549f4e5f88d7/11102_2021_1153_Fig4_HTML.jpg

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