256 例肝移植受者的健康相关生活质量。
Health-related quality of life of 256 recipients after liver transplantation.
机构信息
Department of Liver and Vascular Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
出版信息
World J Gastroenterol. 2012 Sep 28;18(36):5114-21. doi: 10.3748/wjg.v18.i36.5114.
AIM
To investigate health-related quality of life (HRQoL) and psychological outcomes in 256 adults who had undergone liver transplantation (LT).
METHODS
A stratified random sampling method was used in this follow-up multicenter study to select a representative sample of recipients undergoing either living donor liver transplantation (LDLT) or deceased donor liver transplantation (DDLT). HRQoL was measured by using the Chinese version of Medical Outcome Study Short Form-36 (SF-36), and psychological outcomes by using the beck anxiety inventory (BAI) and the self-rating depression scale (SDS). Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires.
RESULTS
A total of 256 patients were sampled, including 66 (25.8%) receiving LDLT and 190 (74.2%) undergoing DDLT; 15 (5.9%) recipients had anxiety and four (1.6%) developed severe depression after the operation. Compared with LDLT recipients, DDLT patients had higher scores in general health (60.33 ± 16.97 vs 66.86 ± 18.42, P = 0.012), role-physical (63.64 ± 42.55 vs 74.47 ± 36.46, P = 0.048), role-emotional (61.11 ± 44.37 vs 78.95 ± 34.31, P = 0.001), social functioning (78.60 ± 22.76 vs 88.16 ± 21.85, P = 0.003), vitality (70.30 ± 15.76 vs 75.95 ± 16.40, P = 0.016), mental health (65.88 ± 12.94 vs 71.85 ± 15.45, P = 0.005), physical component summary scale (PCS, 60.07 ± 7.36 vs 62.58 ± 6.88, P = 0.013) and mental component summary scale (MCS, 52.65 ± 7.66 vs 55.95 ± 10.14, P = 0.016). Recipients > 45 years old at the time of transplant scored higher in vitality (77.33 ± 15.64 vs 72.52 ± 16.66, P = 0.020), mental health (73.64 ± 15.06 vs 68.00 ± 14.65, P = 0.003) and MCS (56.61 ± 10.00 vs 54.05 ± 9.30, P = 0.037) than those aged ≤ 45 years. MCS was poorer in recipients with than in those without complications (52.92 ± 12.21 vs 56.06 ± 8.16, P = 0.017). Regarding MCS (55.10 ± 9.66 vs 50.0 ± 10.0, P < 0.05) and PCS (61.93 ± 7.08 vs 50.0 ± 10.0, P < 0.05), recipients scored better than the Sichuan general and had improved overall QoL compared to patients with chronic diseases. MCS and PCS significantly correlated with scores of the BAI (P < 0.001) and the SDS (P < 0.001).
CONCLUSION
Age > 45 years at time of transplant, DDLT, full-time working, no complications, anxiety and depression were possible factors influencing postoperative HRQoL in liver recipients.
目的
调查 256 名接受过肝移植（LT）的成年人的健康相关生活质量（HRQoL）和心理结果。
方法
本研究采用分层随机抽样方法，从接受活体供肝移植（LDLT）或尸体供肝移植（DDLT）的受者中选择具有代表性的样本。使用中文版医疗结局研究短表 36 项（SF-36）评估 HRQoL，使用贝克焦虑量表（BAI）和自评抑郁量表（SDS）评估心理结果。临床和人口统计学数据来自中国肝移植注册中心的记录和问卷调查。
结果
共抽取 256 例患者，其中 66 例（25.8%）接受 LDLT，190 例（74.2%）接受 DDLT；术后 15 例（5.9%）患者出现焦虑，4 例（1.6%）患者出现严重抑郁。与 LDLT 受者相比，DDLT 患者的一般健康状况评分较高（60.33±16.97 与 66.86±18.42，P=0.012），角色身体状况（63.64±42.55 与 74.47±36.46，P=0.048），角色情感（61.11±44.37 与 78.95±34.31，P=0.001），社会功能（78.60±22.76 与 88.16±21.85，P=0.003），活力（70.30±15.76 与 75.95±16.40，P=0.016），心理健康（65.88±12.94 与 71.85±15.45，P=0.005），生理成分综合评分（PCS，60.07±7.36 与 62.58±6.88，P=0.013）和心理成分综合评分（MCS，52.65±7.66 与 55.95±10.14，P=0.016）较高。移植时年龄>45 岁的受者活力（77.33±15.64 与 72.52±16.66，P=0.020），心理健康（73.64±15.06 与 68.00±14.65，P=0.003）和 MCS（56.61±10.00 与 54.05±9.30，P=0.037）评分较高。与无并发症的受者相比，有并发症的受者 MCS 评分较差（52.92±12.21 与 56.06±8.16，P=0.017）。MCS（55.10±9.66 与 50.0±10.0，P<0.05）和 PCS（61.93±7.08 与 50.0±10.0，P<0.05），受者评分优于四川一般人群，与慢性病患者相比，整体生活质量得到改善。MCS 和 PCS 与 BAI（P<0.001）和 SDS（P<0.001）评分显著相关。
结论
移植时年龄>45 岁、DDLT、全职工作、无并发症、焦虑和抑郁可能是肝移植受者术后 HRQoL 的影响因素。
Zotero 插件