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巨细胞动脉炎及其治疗对患者生活质量的影响:一项单中心自我评估研究。

Impact of Giant Cell Arteritis and Its Treatment on the Patient's Quality of Life: A Single-Center Self-Assessment Study.

作者信息

de Boysson Hubert, Barakat Clivia, Dumont Anael, Boutemy Jonathan, Martin Silva Nicolas, Maigné Gwénola, Nguyen Alexandre, Lavergne Amandine, Castan Paul, Gallou Sophie, Sultan Audrey, Deshayes Samuel, Aouba Achille

机构信息

Department of Internal Medicine, Caen University Hospital, Caen, France.

Caen University-Normandie, Caen, France.

出版信息

Front Med (Lausanne). 2021 Nov 10;8:777310. doi: 10.3389/fmed.2021.777310. eCollection 2021.

DOI:10.3389/fmed.2021.777310
PMID:34859020
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8631395/
Abstract

Little is known about the impact of giant cell arteritis (GCA) and its treatment on patient-reported physical, mental, and psychic quality of life (QoL). In this monocentric study, a questionnaire was sent to the 100 last patients diagnosed with GCA and followed-up in a single tertiary center. Their physical, mental and psychic status were self-assessed via close-ended questions, the 12-item short form survey (SF-12) and the 15-item geriatric depression scale (GDS). We aimed to identify parameters that were significantly associated with moderate-to-severe disability in both physical and mental domains. Ninety patients were analyzable. Moderate to severe physical disability was found in 41 (46%) patients. In multivariate analysis, walking difficulties (OR, 95% CI 8.42 [2.98-26.82], <0.0001), muscle mass and strength reduction (OR, 95% CI 4.38 [1.37-16.31], = 0.01) and age >80 (OR, 95% CI 4.21 [1.44-13.61], = 0.008) were independent findings associated with moderate to severe physical disability. Moderate to severe mental disability was found in 30 (33%) patients. In multivariate analysis, depressive mood (OR, 95% CI 11.05 [3.78-37.11], < 0.0001), felt adverse events attributable to glucocorticoids (OR, 95% CI 10.54 [1.65-213.1], = 0.01) and use of immune-suppressants (OR, 95% CI 3.50 [1.14-11.87], = 0.03) were independent findings associated with moderate to severe mental disability. There was a statistically significant negative correlation between GDS and the physical and/or mental disability scores (GDS and PCS-12: = -0.33, = 0.0013; GDS and MCS-12: = -0.36, = 0.0005). In conclusion, this study identified via a self-assessment of patients with GCA some medical and modifiable findings that significantly affect their physical and mental quality of life. A better knowledge of these factors may help improve the care of GCA patients.

摘要

关于巨细胞动脉炎(GCA)及其治疗对患者报告的身体、心理和精神生活质量(QoL)的影响,目前所知甚少。在这项单中心研究中,向最后100例被诊断为GCA并在单一三级中心接受随访的患者发送了一份问卷。通过封闭式问题、12项简短健康调查(SF - 12)和15项老年抑郁量表(GDS)对他们的身体、心理和精神状态进行自我评估。我们旨在确定在身体和心理领域与中度至重度残疾显著相关的参数。90例患者可进行分析。41例(46%)患者存在中度至重度身体残疾。在多变量分析中,行走困难(比值比[OR],95%置信区间[CI] 8.42 [2.98 - 26.82],P < 0.0001)、肌肉质量和力量下降(OR,95% CI 4.38 [1.37 - 16.31],P = 0.01)以及年龄>80岁(OR,95% CI 4.21 [1.44 - 13.61],P = 0.008)是与中度至重度身体残疾相关的独立因素。30例(33%)患者存在中度至重度精神残疾。在多变量分析中,抑郁情绪(OR,95% CI 11.05 [3.78 - 37.11],P < 0.0001)、感觉归因于糖皮质激素的不良事件(OR,95% CI 10.54 [1.65 - 213.1],P = 0.01)以及使用免疫抑制剂(OR,95% CI 3.50 [1.14 - 11.87],P = 0.03)是与中度至重度精神残疾相关的独立因素。GDS与身体和/或精神残疾评分之间存在统计学显著的负相关(GDS与PCS - 12:P = -0.33,P = 0.0013;GDS与MCS - 12:P = -0.36,P = 0.0005)。总之,本研究通过对GCA患者的自我评估确定了一些医学上可改变的因素,这些因素显著影响他们的身体和精神生活质量。更好地了解这些因素可能有助于改善GCA患者的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b756/8631395/ff7326d0c0f1/fmed-08-777310-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b756/8631395/5000eeaeeabd/fmed-08-777310-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b756/8631395/ff7326d0c0f1/fmed-08-777310-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b756/8631395/5000eeaeeabd/fmed-08-777310-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b756/8631395/ff7326d0c0f1/fmed-08-777310-g0002.jpg

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Semin Arthritis Rheum. 2021 Apr;51(2):360-366. doi: 10.1016/j.semarthrit.2021.01.007. Epub 2021 Jan 27.
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Patient perceptions of health-related quality of life in giant cell arteritis: international development of a disease-specific patient-reported outcome measure.巨细胞动脉炎患者健康相关生活质量的感知:一种疾病特异性患者报告结局测量方法的国际制定。
Rheumatology (Oxford). 2021 Oct 2;60(10):4671-4680. doi: 10.1093/rheumatology/keab076.
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2018 Update of the EULAR recommendations for the management of large vessel vasculitis.
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