Persistence of impaired health status of Q fever patients 4 years after the first Dutch outbreak
Persistence of impaired health status of Q fever patients 4 years after the first Dutch outbreak
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DOI：
10.1017/s0950268815002216
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发表时间：
2016-04-01
影响因子：
4.2
通讯作者：
Nabuurs-Franssen, M. H.
中科院分区：
文献类型：
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作者：
Limonard, G. J. M.;Peters, J. B.;Nabuurs-Franssen, M. H.
2007年荷兰首次Q热暴发的Q热患者中有很大一部分在感染后1年内健康状况受损。感兴趣的是这种健康状况的下降是否持续，我们着手确定同一队列患者的健康状况，原发性感染后4年，并比较1年至4年随访期间个体患者水平的健康状况评分。健康状况进行了评估与Nijmegen临床筛选工具（NCSI）。对患者进行血清学检测，以排除可能、可能或已证实的慢性Q热患者。组水平[2008年（n=54）和2011年（n=46）]的NCSI子领域结果显示，所有NCSI子领域表现出临床相关（严重）评分的患者百分比持续显著。4年后，46%的患者出现过度疲劳，恰好有一半的患者的总体生活质量严重受损。在2008年和2011年获得NCSI评分的患者（n=37）显示，除2011年呼吸困难情绪略有下降外，所有子域评分均无差异。在该组中，很大比例的患者在一个或多个健康状况子领域改善或恶化。我们的结论是，在组水平上，Q热患者的健康状况仍然受损4年后，原发性感染。在个体患者层面，健康状况可能会发生变化。
A significant proportion of Q fever patients from the first Dutch Q fever outbreak in 2007 showed impairment in health status up to 1 year after infection. Interested in whether this decrease in health status persisted, we set out to determine the health status in the same cohort of patients, 4 years after primary infection and to compare health status scores at the individual patient level between 1 and 4 years follow-up. Health status was assessed with the Nijmegen Clinical Screening Instrument (NCSI). Patients were serologically tested to exclude patients with possible, probable or proven chronic Q fever. Results on the NCSI sub-domains at group level [2008 (n=54) and 2011 (n=46)] showed a persistent significant percentage of patients exhibiting clinically relevant (severe') scores for all NCSI sub-domains. After 4 years, undue fatigue was present in 46% and exactly half of all patients experienced a severely impaired general quality of life. Patients with NCSI scores available in both 2008 and 2011 (n=37) showed no difference in all sub-domain scores, except for a small decrease in dyspnoea emotions in 2011. In this group, a significant proportion of patients either improved or worsened in one or more sub-domains of health status. We conclude that at the group level, health status of Q fever patients remained impaired 4 years after primary infection. At the individual patient level, health status may change.