Health-related quality of life in patients with idiopathic pulmonary fibrosis: a systematic review
Health-related quality of life in patients with idiopathic pulmonary fibrosis: a systematic review
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DOI：
10.1136/thx.2004.035220
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发表时间：
2005-07-01
期刊：
影响因子：
10
通讯作者：
Gould, MK
中科院分区：
文献类型：
--
作者：
Swigris, JJ;Kuschner, WG;Gould, MK
背景：特发性肺纤维化（IPF）严重影响患者的生活质量。进行了系统的回顾，以严格评价已发表的文献，并检查什么是已知的健康相关的生活质量（HRQL）在IPF patients.Methods：MEDLINE，EMBASE，健康和心理社会工具，和科克伦图书馆数据库进行了检索，2004年4月1日。扫描已发表文章的摘要和参考书目，并与研究者联系。纳入的研究分析了至少10例IPF患者的HRQL（或生活质量）。两名评价者独立选择研究，根据预定的标准评价其质量，并提取研究设计、患者人口统计学和临床特征以及生活质量结局测量的数据。这些研究入组了512例IPF患者，并使用三种不同的工具测量HRQL。所有研究在方法学质量上都有重要的局限性;没有一项研究测量了HRQL随时间的纵向变化。患者报告严重受损的HRQL，特别是在测量身体健康和独立水平的领域。IPF患者的HRQL损害似乎与慢性阻塞性肺疾病患者相似。呼吸困难的指标与衡量身体健康的领域的评分中度相关（R-2 = 0.03 - 0.66）和能量/疲劳/pep（R-2 = 0.19 - 0.55），但肺功能和气体交换的测量与这些和其他领域的相关性并不强。在IPF患者中进行的HRQL研究表明，除了对身体健康的明显影响外，一般健康状况、能量水平、呼吸道症状和独立性水平也会受损。呼吸困难或肺功能指标不能完全解释患者HRQL的变异性，表明HRQL指标提供了独特的信息。需要更多的研究来确定或设计适用于IPF患者的测量工具，并检查HRQL随时间的变化或对特定治疗的反应。
Background: Idiopathic pulmonary fibrosis (IPF) profoundly affects the quality of patients' lives. A systematic review was performed to evaluate critically the published literature and to examine what is known about health-related quality of life (HRQL) in patients with IPF.Methods: The MEDLINE, EMBASE, Health and Psychosocial Instruments, and Cochrane Library databases were searched to 1 April 2004. Abstracts and bibliographies of published articles were scanned and contact was made with investigators. Included studies analysed HRQL ( or quality of life) in at least 10 patients with IPF. Two reviewers independently selected studies, evaluated their quality according to predetermined criteria, and abstracted data on study design, patients' demographic and clinical characteristics, and quality of life outcome measures.Results: Seven studies met the inclusion criteria. The studies enrolled 512 patients with IPF and used three different instruments to measure HRQL. All studies had important limitations in methodological quality; none measured longitudinal changes in HRQL over time. Patients reported substantially impaired HRQL, especially in domains that measured physical health and level of independence. Patients with IPF appear to have similar impairments in HRQL to those with chronic obstructive pulmonary disease. Measures of dyspnoea were moderately correlated with scores from domains that measured physical health (R-2 = 0.03 - 0.66) and energy/fatigue/pep (R-2 = 0.19 - 0.55), but measures of pulmonary function and gas exchange did not correlate as strongly with these and other domains.Conclusion: Studies of HRQL in patients with IPF suggest that, in addition to the obvious effect on physical health, general health, energy level, respiratory symptoms, and level of independence are also impaired. Variability in HRQL among patients is not fully explained by measures of dyspnoea or pulmonary function, suggesting that HRQL measures provide unique information. More research is needed to identify or design appropriate measurement instruments for patients with IPF and to examine changes in HRQL over time or in response to specific treatments.