S-腺苷蛋氨酸对HBV感染相关肝功能衰竭患者生存质量的影响

Effect of S-adenosylmethionine on quality of life in patients with hepatitis B virus-related liver failure

目的调查HBV感染相关肝功能衰竭患者的生存质量(QOL),并评价S-腺苷蛋氨酸对患者QOL的影响。方法选择60例HBV感染相关的慢加亚急性肝功能衰竭中期患者(其中包括S-腺苷蛋氨酸治疗组和非S-腺苷蛋氨酸治疗组患者各30例)作为研究对象,同时以60例健康体检者作为对照组,分别测定各组患者不同阶段生存质量的简明健康状况问卷(SF-36)中文版各维度分数及总分,并进行统计学分析。结果与健康对照组比较,治疗前HBV感染相关肝功能衰竭患者的SF-36中文版各维度分数及总分均下降(P<0.05);S-腺苷蛋氨酸治疗组和非S-腺苷蛋氨酸治疗组的各维度分数及总分差异无统计学意义,但在治疗2周和治疗4周后,S-腺苷蛋氨酸治疗组的各维度分数及总分均高于同期非S-腺苷蛋氨酸治疗组(P<0.05);对S-腺苷蛋氨酸治疗组患者在治疗2周后与治疗前比较,治疗4周与治疗2周后比较,各维度分数与总分均显著提高(P<0.05);而非S-腺苷蛋氨酸治疗组治疗2周后与治疗前比较,仅生理职能、精力、精神健康及总分值有所提高,且具有统计学意义(t=11.400,P=0.000;t=2.340,P=0.026;t=2.567,P=0.016;t=15.031,P=0.000),治疗4周后与治疗2周后相比,情感职能改善情况差异无统计学意义(t=1.795,P=0.083)。结论 HBV感染相关肝功能衰竭患者的QOL状况降低,S-腺苷蛋氨酸能够有效提高患者的QOL状况,且起效较快。

Objective To investigate the quality of life in patients with hepatitis B virus-related liver failure, and then evaluate the effects on quality of life （QOL） following treatment with S-adenosylmethionine （SAMe）. Methods Total of 60 normal subjects and 60 patients in metaphase of subacute on chronic liver failure were recruited for research. And they were randomly divided into two groups as SAMe treatment group and non-SAMe treatment group （n = 30 each） , The Short Form 36 Health Survey Questionnaire （SF-36） was utilized to assess each domain score and the whole score in different phase, and then t-test and Chi-square test were applied to analyze the date. Results At baseline, all patients showed descent in QOL in each domain and the whole score compared to normal subjects （P 〈 0.05）, but there was no statisticall difference in SAMe treatment group and non-SAMe treatment group. Over 2 and 4 weeks, SAMe treatment group showed improvement in QOL in each domain and the whole score compared to non-SAMe treatment group in the corresponding period （P 〈 0.05）. In the meantime, SAMe treatment group showed improvement in QOL in each domain and the whole score over 2 weeks compared to baseline, and over 4 weeks compared to over 2 weeks （P 〈 0.05 ）. But non-SAMe treatment group showed improvement in QOL in several domains such as role-physical, validity, mental health and the whole score over 2 weeks compared to the baseline （t= 11.400, P= 0.000; t= 2.340, P= 0.026; t= 2.567, P= 0.016; t= 15. 031, P = 0.000, respectively） , and no significant difference in role-emotional over 4 weeks compared to over 2 weeks （ t = 1. 795, P = 0. 083 ）. Conclusions Patients in metaphase of subacute on chronic liver failure have poor QOL, which could be significantly and quickly improved after treatment with SAMe.