慢性乙型肝炎患者抗病毒治疗后生存质量评估

An evaluation on quality of life in patients with chronic hepatitis B after antiviral therapy: health questionnaire survey

目的了解慢性乙型肝炎(CHB)患者生存质量(QOL)状况,并通过抗病毒治疗对其QOL进行干预。方法采用横断面调查,选择2003年至2004年期间武汉大学人民医院感染科212例慢性乙型肝炎患者及健康人群185例,分别以健康状况问卷(SF-36)、医学应对问卷以及肝病特质问卷进行调查。结果与健康对照组比较,CHB患者除情感职能(RE)外,其他维度得分均明显低于健康对照者(P<0.05)。CHB患者QOL与年龄、肝病特质问卷得分以及医学应对问卷中的屈服、面对因子分显著负相关(P<0.01)。虽然不同抗病毒治疗方案对CHB患者QOL的影响差异无统计学意义,但完全应答组与无应答组比较,两组除社会功能(SF)(P<0.05)以外其他维度的得分差异均有统计学意义(P<0.01);部分应答组与无应答组比较,仅RE、躯体疼痛(BP)及一般健康状况(GH)维度的得分差异有统计学意义(P<0.05)。结论CHB患者QOL多个纬度均有受损。有效的抗病毒治疗能提高患者的QOL。

Objective To explore the quality of life （QOL） for the patients with chronic hepatitis B （CHB）. And the intervention effect of antl-viral therapy on QOL in patients with CHB was investigated. Methods A cross-sectional study based on 212 patients with CHB was carried out in the department of infectious diseases, Renmin Hospital of Wuhan University, using SF36 questionnaire, special hepatitis questionnaire and medical coping modes questionnaire （MCMQ） during 2003 to 2004. Results Compared with healthy controls, patients with CHB had lower QOL on all scales of the SF36 （P 〈 0.05） except for Role-Emotional （RE）. There was no difference of QOL among different an ti-viral therapy groups （P 〉 0.05）. The reduction in QOL was directly associated with age, the scores of special hepatitis questionnaire, confrontation and resignation in MCMQ （P 〈 0.01）. The difference of QOL between complete response group and non-response group is significant （P 〈 0. 01） except for Social Function （SF） （P〈 0.05）. Although compared with non response group, only Role Emotional （RE）, Body Pain （BP） and General Health （GH） in part response group were better （P〈 0.05）. Conclusion The QOL of patients with CHB was damaged. And effective anti-viral therapy would improve the QOL.