Fisher D C, Lake K D, Reutzel T J, Emery R W
Behavioral Medicine Clinic, Abbott Northwestern Hospital, Minneapolis, MN 55407, USA.
J Heart Lung Transplant. 1995 Mar-Apr;14(2):373-81.
The intent of this study was to measure health-related quality of life and depression in 94 heart transplant recipients.
Changes in health-related quality of life and depression were examined by administering the Sickness Impact Profile and the Beck Depression Inventory before heart transplantation, as well as 4, 8, 12, 24, 36, 48, and 60 months after surgery.
Sickness Impact Profile scores obtained before heart transplantation highlighted the greatest health-related quality of life dysfunction in work, sleep and rest, home management, and recreation and pastimes. Posttransplantation measures suggested improvement (p < 0.05) in emotional behavior, home management, mobility, ambulation, depression, eating behavior, social interaction, body care and movement, sleep and rest, recreation and pastimes, depression, and physical, overall, and psychosocial functioning. Continued improvement was noted up to 5 years after transplantation although patients continued to have marked work-related dysfunction. Age, medication regimen, rejection episodes, and a variety of preoperative medical variables were not related to health-related quality of life. Actuarial survival rates at 1, 2, 3, 4, and 5 years were 89%, 87%, 80%, 79%, and 79%, respectively.
Our results suggest that as early as 4 months after heart transplantation, patients show excellent functioning in most health-related quality of life areas. Survival rates are encouraging. Patients did not generally experience problems with depression within the first 4 months after heart transplantation. Notable problems remain after transplantation in rate of return to work where only 53% returned to work by 5 years after heart transplantation.
本研究旨在评估94名心脏移植受者的健康相关生活质量和抑郁情况。
通过在心脏移植术前以及术后4、8、12、24、36、48和60个月时实施疾病影响量表和贝克抑郁量表，来检测健康相关生活质量和抑郁的变化。
心脏移植术前获得的疾病影响量表评分显示，在工作、睡眠与休息、家庭管理以及娱乐消遣方面，健康相关生活质量功能障碍最为严重。移植后的测量结果表明，在情绪行为、家庭管理、活动能力、行走、抑郁、饮食行为、社交互动、身体护理与活动、睡眠与休息、娱乐消遣、抑郁以及身体、总体和心理社会功能方面均有改善（p < 0.05）。尽管患者在工作相关功能方面仍存在明显障碍，但移植后5年内仍持续改善。年龄、药物治疗方案、排斥反应发作以及各种术前医学变量与健康相关生活质量无关。1年、2年、3年、4年和5年的精算生存率分别为89%、87%、80%、79%和79%。
我们的结果表明，心脏移植术后早在4个月时，患者在大多数健康相关生活质量领域就表现出良好的功能。生存率令人鼓舞。心脏移植术后的前4个月内，患者一般不会出现抑郁问题。移植后在重返工作率方面仍存在显著问题，心脏移植术后5年时只有53%的患者重返工作岗位。
