Dynamics and Liver Disease Specific Aspects of Quality of Life Among Patients with Chronic Liver Disease in Yunnan, China
Dynamics and Liver Disease Specific Aspects of Quality of Life Among Patients with Chronic Liver Disease in Yunnan, China
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DOI：
10.7314/apjcp.2014.15.12.4765
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发表时间：
2014-01-01
影响因子：
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通讯作者：
Zhang, Ru-Yi
中科院分区：
文献类型：
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作者：
Che, Yan-Hua;You, Jing;Zhang, Ru-Yi
背景：慢性肝病患者（CLD）可能损害与健康相关的生活质量（HRQOL）。肝炎病毒（HBV）感染一直是CLD的主要原因，包括肝癌和肝硬化。关于CLD不同症状概况的知识应有助于制定全面的治疗和患者护理计划。目的：在其严重程度的整个慢性肝疾病中访问HRQOL的方面。材料和方法：在中国云南省的昆明医科大学第一家附属医院进行了一项横断面研究。从2012年12月至2013年6月，均可针对不同HBV相关的肝脏疾病状态进行治疗方案的两名外科医生。使用ANOVA比较5个疾病组中EQ-5D和慢性肝病问卷（CLDQ）的平均得分。分析了预测全局CLDQ得分的人口变量与CLDQ域之间的关系。结果：总共1040名患者，包括520例无并发症，91例具有补偿性肝硬化，肝硬化的198例，HCC 131和100例患有肝衰竭。 CLDQ的所有领域，EQ-5D值和EQ VA的平均值均显着下降，疾病严重程度从简单的HBV到肝衰竭，疾病的严重程度恶化。多元回归表明在高级阶段的CLDQ结构域的平均得分降低。肝衰竭和HCC患者的HRQOL损害比其他疾病状态更多。找不到患者性别的影响。患者年龄与“疲劳”和“忧虑”域相关（p = 0.006； p = 0.004），但与其他域和CLDQ和ED-5D的全球得分无关。结论：慢性丙型肝炎患者的HRQOL受疾病状态极大的影响。护理与HBV相关疾病的护理不仅应考虑治疗策略的结果，还应考虑患者健康的改善。
Background: Patients with chronic liver diseases (CLD) may have compromised health related quality of life (HRQoL). Hepatitis B virus (HBV) infection has long been the leading cause of CLD including liver cancer and cirrhosis. Knowledge on different symptom profiles of CLD should help in development of comprehensive treatment and patient care plans. Objective: To access the facets of HRQoL in chronic liver diseases throughout their spectrum of severity. Materials and Methods: A cross-sectional study was conducted in the First Affiliated Hospital of Kunming Medical University in Yunnan Province of China. Both out-and inpatients undergoing treatment protocols for different HBV related liver disease states were consecutively collected from December 2012 to June 2013. ANOVA was used to compare the mean scores of EQ-5D and chronic liver disease questionnaire (CLDQ) among 5 disease groups. The relationship between demographic variables predicting global CLDQ scores and the domains of CLDQ was analysed. Results: A total of 1040 patients including 520 without complications, 91 with compensated cirrhosis, 198 with decompensated cirrhosis, 131 with HCC and 100 with liver failure were recruited. All domains of CLDQ, the means of EQ-5D value and EQ VAS exhibited significant decline with worsening of disease severity from uncomplicated HBV to liver failure. The multivariate regression demonstrated the reduction of mean scores of CLDQ domain at advanced stage. Patients with liver failure and HCC had more HRQoL impairment than other disease states. No effect of patient gender was found. Patient age was associated with 'fatigue' and 'worry' domains (p=0.006; p=0.004) but not with other domains and global scores of CLDQ and ED-5D. Conclusions: The HRQoL in chronic hepatitis B patients is greatly affected by disease states. Care for HBV-related diseases should consider not only the outcomes of treatment strategies but also improvement in patient wellbeing.