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中国甘肃肺动脉高压患者的生活印记:临床相关特征与生活质量

Impression life with pulmonary hypertension: clinically relevant characteristics and quality of life among patients in Gansu, China.

作者信息

Zhang Juxia, Wen Yujie, Yin Yuhuan, Zhang Yiyin, Zhang Rong, Zhang Xiaoli, Ye Jianying, Feng Yuping, Meng Hongyan

机构信息

Clinical Educational Department, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China.

Cardiovascular Department, Gansu Provincial Hospital, Lanzhou, Gansu, China.

出版信息

Ther Adv Respir Dis. 2024 Jan-Dec;18:17534666241246428. doi: 10.1177/17534666241246428.

Abstract

BACKGROUND

The adverse effects of pulmonary arterial hypertension (PAH) on physical, emotional, and health-related quality of life (HRQoL) remain primarily unrecognized, especially in resource-limited settings.

OBJECTIVES

This study aims to characterize the HRQoL of patients with PAH in this area and also identify the potential role of clinically relevant characteristics, including the 6-min walk distance test (6MWD), WHO-Functional Classification (WHO-FC), and mental health in the occurrence of lowering quality of life.

DESIGN

This was a cross-sectional observational study.

METHODS

Inpatients with PAH were chosen from a tertiary hospital located in Gansu province, China. All participants were interviewed face-by-face by using questionnaires, including items from the 36-Item Short Form Health Survey (SF-36), the self-rating anxiety scale, and the self-rating depression scale. Data on demographic and clinically relevant characteristics, including WHO-FC and 6MWD, were also collected by tracing medical recorders. Multiple linear regression analysis was used to determine the association between demographic, clinically relevant characteristics data, and physical component summary (PCS) or mental component summary (MCS) in SF-36.

RESULTS

Of the 152 participants, SF-36 differed significantly from Chinese norms in all eight domains, with role-physical (21.55 ± 9.87) less than one-third of the norm (88.79 ± 28.49). Multiple linear regression results showed that the factors with the greatest impact on PCS were anxiety scores (β = -0.22,  = 0.001), followed by WHO-FC (β = -0.16,  = 0.014) and 6MWD (β = 0.15,  = 0.036). The factors with the greatest impact on MCS were WHO-FC (β = -0.30,  < 0.001), followed by anxiety (β = -0.23,  = 0.001) and depression scores (β = -0.16,  = 0.013).

CONCLUSION

HRQoL was substantially reduced among PAH patients in the resource-limited area, mainly the physiological functions. WHO-FC and anxiety scores were independently associated with both PCS and MCS in SF-36. Clinicians should make reasonable rehabilitation programs and plans for patients according to their cardiac function grade and the severity of clinical symptoms. In addition, psychological interventions should also be taken, especially for those with anxiety symptoms, so as to improve their HRQoL.

摘要

背景

肺动脉高压(PAH)对身体、情绪及健康相关生活质量(HRQoL)的不良影响仍未得到充分认识,尤其是在资源有限的地区。

目的

本研究旨在描述该地区PAH患者的HRQoL,并确定临床相关特征(包括6分钟步行距离测试(6MWD)、世界卫生组织功能分级(WHO-FC)和心理健康)在生活质量下降发生中的潜在作用。

设计

这是一项横断面观察性研究。

方法

从中国甘肃省一家三级医院选取PAH住院患者。所有参与者均通过问卷调查进行面对面访谈,问卷包括来自36项简短健康调查问卷(SF-36)、自评焦虑量表和自评抑郁量表的项目。还通过查阅病历收集人口统计学和临床相关特征数据,包括WHO-FC和6MWD。采用多元线性回归分析来确定人口统计学、临床相关特征数据与SF-36中的身体成分总结(PCS)或心理成分总结(MCS)之间的关联。

结果

152名参与者中,SF-36在所有八个领域均与中国常模有显著差异,其中角色-身体(21.55±9.87)低于常模(88.79±28.49)的三分之一。多元线性回归结果显示,对PCS影响最大的因素是焦虑评分(β = -0.22,P = 0.001),其次是WHO-FC(β = -0.16,P = 0.014)和6MWD(β = 0.15,P = 0.036)。对MCS影响最大的因素是WHO-FC(β = -0.30,P < 0.001),其次是焦虑(β = -0.23,P = 0.001)和抑郁评分(β = -0.16,P = 0.013)。

结论

在资源有限地区,PAH患者的HRQoL大幅降低,主要是生理功能方面。WHO-FC和焦虑评分与SF-36中的PCS和MCS均独立相关。临床医生应根据患者的心功能分级和临床症状严重程度为患者制定合理的康复计划。此外,还应采取心理干预措施,尤其是对有焦虑症状的患者,以提高他们的HRQoL。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7df8/11055475/4a2237cf03db/10.1177_17534666241246428-fig1.jpg

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