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中国阵发性睡眠性血红蛋白尿症患者的健康相关生活质量及其影响因素。

Health-related quality of life and influencing factors of patients with paroxysmal nocturnal hemoglobinuria in China.

机构信息

School of Public Health, Dalian Medical University, Dalian, China.

School of Public Health, Fudan University, 130 Dong An Road, Shanghai, China.

出版信息

Orphanet J Rare Dis. 2024 May 3;19(1):186. doi: 10.1186/s13023-024-03178-x.

Abstract

BACKGROUND

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare blood disorder, leading to various complications and impairments in patients' health-related quality of life (HRQOL). Limited research has been conducted to evaluate the HRQOL of Chinese patients with PNH. Understanding the HRQOL in this specific population is crucial for providing effective healthcare interventions and improving patient' health outcomes. This study aimed to assess HRQOL of Chinese patients with PNH, and identify key determinants.

METHODS

A cross-sectional study was conducted during 2022 to recruit patients with PNH in China. The study population was recruited from PNH China, one of the largest public welfare PNH patient mutual aid organization in China. Data were collected via an online questionnaire including the EQ-5D-5L (5L), and social-demographic and clinical characteristics. Descriptive statistics were employed to summarize the characteristics of the participants and their HRQOL. Multiple linear and logistic regression analyses were adopted to explore key factors affecting HRQOL.

RESULTS

A total of 329 valid questionnaires were collected. The mean (SD) age of the patients was 35.3 (10.0) years, with 52.3% of them being male. The patients reported more problems in Anxiety/Depression (81.5%) and Pain/Discomfort (69.9%) dimensions compared to the other three 5L dimensions. The mean (SD) of 5L health utility score (HUS) and EQ-VAS score were 0.76 (0.21) and 62.61 (19.20), respectively. According to multiple linear regression, initial symptoms (i.e., Anemia [fatigue, tachycardia, shortness of breath, headache] and back pain) and complication of thrombosis were significant influencing factors affecting 5L HUS. Total personal income of the past year, initial symptom of hemoglobinuria and complication of thrombosis were significantly influencing factors of VAS score. Social-demographic and clinical characteristics, such as gender, income, and thrombosis, were also found to be significantly related to certain 5L health problems as well.

CONCLUSION

Our study manifested the HRQOL of PNH patients in China was markedly compromised, especially in two mental-health related dimensions, and revealed several socio-demographic and clinical factors of their HRQOL. These findings could be used as empirical evidence for enhancing the HRQOL of PNH patients in China.

摘要

背景

阵发性夜间血红蛋白尿症(PNH)是一种罕见的血液疾病,导致患者的健康相关生活质量(HRQOL)出现各种并发症和受损。针对中国 PNH 患者的 HRQOL 进行的研究有限。了解这一特定人群的 HRQOL 对于提供有效的医疗干预措施和改善患者的健康结果至关重要。本研究旨在评估中国 PNH 患者的 HRQOL,并确定关键决定因素。

方法

2022 年进行了一项横断面研究,以招募中国的 PNH 患者。研究人群来自中国 PNH 患者组织,这是中国最大的公益 PNH 患者互助组织之一。通过在线问卷收集数据,包括 EQ-5D-5L(5L)以及社会人口统计学和临床特征。采用描述性统计方法总结参与者的特征及其 HRQOL。采用多元线性和逻辑回归分析探讨影响 HRQOL 的关键因素。

结果

共收集了 329 份有效问卷。患者的平均(SD)年龄为 35.3(10.0)岁,其中 52.3%为男性。与其他 5L 维度相比,患者在焦虑/抑郁(81.5%)和疼痛/不适(69.9%)维度报告了更多问题。5L 健康效用评分(HUS)和 EQ-VAS 评分的平均(SD)分别为 0.76(0.21)和 62.61(19.20)。根据多元线性回归分析,首发症状(即贫血[疲劳、心动过速、呼吸急促、头痛]和背痛)和血栓并发症是影响 5L HUS 的显著影响因素。过去一年的个人总收入、首发血尿症状和血栓并发症是 VAS 评分的显著影响因素。社会人口统计学和临床特征,如性别、收入和血栓形成,也被发现与某些 5L 健康问题显著相关。

结论

我们的研究表明,中国 PNH 患者的 HRQOL 明显受损,尤其是在两个心理健康相关维度,并且揭示了影响其 HRQOL 的几个社会人口统计学和临床因素。这些发现可以作为提高中国 PNH 患者 HRQOL 的实证依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e04/11067208/d984febdfead/13023_2024_3178_Fig1_HTML.jpg

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