Glasziou P P, Bromwich S, Simes R J
Department of Social and Preventive Medicine, University of Queensland, Herston.
Med J Aust. 1994 Nov 7;161(9):532-6. doi: 10.5694/j.1326-5377.1994.tb127596.x.
To assess and compare quality of life of patients six months after an acute myocardial infarction treated with one of two thrombolytic agents, streptokinase (SK) or recombinant tissue plasminogen activator (tPA).
A cohort study of consecutive patients randomly allocated to thrombolytic therapy and treated in hospitals participating in the Australian arm of the International tPA/SK Mortality Trial (AUS-TASK).
776 patients with acute myocardial infarction were asked to complete questionnaires at their follow-up clinic visit six months after the infarct.
Two measures were used: (i) the York Health Measurement Questionnaire, which measures activities and distress and provides basic descriptors of quality of life; and (ii) a time trade-off question about the number of years a person would be willing to give up in exchange for returning to full health.
The quality of life of the 714 respondents (92%) was generally high, with a mean index of 0.98. The five main areas causing distress were: lack of energy; breathlessness; anxiety; difficulty sleeping; and pain. In the time trade-off question, the mean number of years respondents were willing to forgo, out of 15 years, was 0.87 years; while 76% did not think it worthwhile to forgo any time. The 8% of patients who declined to answer the questionnaire were in significantly poorer health (New York Heart Association classification, P = 0.01; and Karnofsky index, P < 0.001). There were no significant differences in quality of life or time trade-off answers between patients allocated to streptokinase or tPA (P = 0.96 and 0.73, respectively).
Quality of life six months after myocardial infarction is generally high, and most patients are able to return to normal activities. However, it is significantly impaired in a small group of patients, mainly those with a subsequent stroke or re-infarction. There was no significant difference in quality of life between those treated with tPA and those with streptokinase.
评估并比较使用两种溶栓药物之一，即链激酶（SK）或重组组织型纤溶酶原激活剂（tPA）治疗急性心肌梗死后六个月患者的生活质量。
一项队列研究，研究对象为连续入选并随机接受溶栓治疗的患者，这些患者在参与国际tPA/SK死亡率试验澳大利亚分部（AUS-TASK）的医院接受治疗。
776例急性心肌梗死患者被要求在心肌梗死后六个月的随访门诊就诊时完成问卷调查。
使用了两项指标：（i）约克健康测量问卷，该问卷测量活动和痛苦程度，并提供生活质量的基本描述；（ii）一个时间权衡问题，询问一个人愿意放弃多少年以换取恢复完全健康。
714名受访者（92%）的生活质量总体较高，平均指数为0.98。导致痛苦的五个主要方面为：缺乏精力、呼吸急促、焦虑、睡眠困难和疼痛。在时间权衡问题中，受访者在15年中愿意放弃的平均年数为0.87年；而76%的人认为不值得放弃任何时间。8%拒绝回答问卷的患者健康状况明显较差（纽约心脏协会分级，P = 0.01；卡诺夫斯基指数，P < 0.001）。接受链激酶或tPA治疗的患者在生活质量或时间权衡答案方面没有显著差异（分别为P = 0.96和0.73）。
心肌梗死后六个月的生活质量总体较高，大多数患者能够恢复正常活动。然而，一小部分患者的生活质量明显受损，主要是那些随后发生中风或再次梗死的患者。接受tPA治疗的患者和接受链激酶治疗的患者在生活质量方面没有显著差异。
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