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一项前瞻性观察研究,探讨影响原发性醛固酮增多症患者治疗后生活质量变化的因素。

A Prospective Observational Study of Factors Affecting the Change in Quality of Life in Patients With Primary Aldosteronism After Treatment.

机构信息

Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Endocr Pract. 2024 Jan;30(1):19-24. doi: 10.1016/j.eprac.2023.10.003. Epub 2023 Oct 18.

Abstract

OBJECTIVE

To explore the changes in the health-related quality of life (HRQoL) in patients with primary aldosteronism (PA) after standardized treatment and determine the effects of different variables on the change in the HRQoL of patients.

METHODS

A total of 116 patients with PA were prospectively included from November 2020 to March 2022. Data were collected at their initial diagnosis and the follow-up after 12 months of treatment, including demographic and clinical data and the scores of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The scores of each dimension of SF-36 of patients before and after treatment were compared, and the factors affecting their change in the quality of life were analyzed using multiple linear regression.

RESULTS

After standardized treatment, the aldosterone-to-renin ratio (Z = -4.967, P < .001), systolic blood pressure (t = 8.985, P < .001), and diastolic blood pressure (t = 7.233, P < .001) of patients with PA decreased compared with baseline, and hypokalemia was effectively corrected (χ = 69.014, P < .001). In terms of quality of life, 6 of 8 dimensions of SF-36 and the total score of SF-36 significantly improved at 1-year follow-up compared with baseline (all P < .05). The results of multiple linear regression showed that the improvement in the HRQoL in patients with PA after standardized treatment was correlated with the change in the blood potassium level (P = .007) and systolic blood pressure (P = .003).

CONCLUSION

Correction of hypokalemia and control of diastolic blood pressure are essential factors contributing to the improvement in the HRQoL in patients with PA regardless of the standardized treatment received.

摘要

目的

探讨原发性醛固酮增多症(PA)患者经标准化治疗后健康相关生活质量(HRQoL)的变化,并确定不同变量对患者 HRQoL 变化的影响。

方法

前瞻性纳入 2020 年 11 月至 2022 年 3 月期间的 116 例 PA 患者。收集患者初诊时和治疗后 12 个月的人口统计学和临床数据以及医疗结局研究 36 项简明健康调查量表(SF-36)评分。比较患者治疗前后各维度 SF-36 评分,并采用多元线性回归分析影响其生活质量变化的因素。

结果

经标准化治疗后,PA 患者的醛固酮/肾素比值(Z=-4.967,P<0.001)、收缩压(t=8.985,P<0.001)和舒张压(t=7.233,P<0.001)较基线降低,低钾血症得到有效纠正(χ²=69.014,P<0.001)。在生活质量方面,与基线相比,SF-36 的 8 个维度中有 6 个维度和 SF-36 的总分在 1 年随访时显著改善(均 P<0.05)。多元线性回归结果显示,PA 患者经标准化治疗后 HRQoL 的改善与血钾水平(P=0.007)和收缩压(P=0.003)的变化相关。

结论

纠正低钾血症和控制舒张压是改善 PA 患者 HRQoL 的重要因素,无论其接受何种标准化治疗。

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