急性白血病患者异基因造血干细胞移植后的长期生活质量及其影响因素

Long⁃term life quality of acute leukemia patients after allogeneic hematopoietic stem cell transplantation and its influencing factors

目的分析急性白血病患者异基因造血干细胞移植后的长期生活质量及其影响因素。方法前瞻性招募2011年1月至2015年12月于广西医科大学第一附属医院行异基因造血干细胞移植的急性白血病患者为研究对象,随访截至2020年6月。采用病例对照研究根据1∶1比例于2020年6月至2020年7月按照年龄(±2岁)、性别、婚姻状况匹配健康人群为对照组。采用中文版SF⁃36量表调查患者移植前、移植1年后和移植5年后的生活质量。采用多重线性回归分析影响患者5年生活质量的因素,并与健康人群进行比较。结果本研究共纳入104例患者进行分析。患者移植前的生活质量总分及各维度得分均较低,移植1年后进一步降低,而移植5年后逐渐恢复(均P<0.05),但5年后移植患者的生活质量仍低于对照组(各维度均P<0.05)。多重线性回归分析显示,移植年龄≥32岁(β=-2.52,95%CI:-3.61 to-1.21,P=0.041)、移植物抗宿主病(β=-3.25,95%CI:-6.34 to-0.21,P=0.022)和移植并发症(β=-5.93,95%CI:-9.71 to-1.24,P=0.037)与较差的5年生活质量相关。结论急性白血病患者接受异基因造血干细胞移植后生活质量逐步改善,积极采取措施预防和治疗移植后相关并发症有助于患者的生活质量恢复到健康人群水平。

Objective To analyze the long⁃term life quality of patients with acute leukemia after allogeneic hematopoietic stem cell transplantation and its influencing factors.Methods The patients with acute leukemia who underwent allogeneic hematopoietic stem cell transplantation in the First Affiliated Hospital of Guangxi Medical University from January 2011 to December 2015 were prospectively recruited as the research subjects,and follow⁃up was up to June 2020.The case⁃control study was performed by one⁃to⁃one matching the patients with the control group chosen from the healthy population from June 2020 to July 2020 according to age(±2 years),gender,and marital status.The Chinese version of the SF⁃36 scale was used to evaluate the life quality of patients before transplantation,1 year after transplantation,and 5 years after transplantation.Multiple linear regression analysis was used to analyze the factors affecting the patients′5⁃year quality of life,and to compare with healthy people.Results A total of 104 patients were included in this study.The total score of life quality and all dimensions before transplantation were low,and decreased 1 year after transplantation,and gradually recovered 5 years after transplantation(all P<0.05).However,the life quality was still lower than that of the control group after 5 years(all dimen⁃sions P<0.05).Multiple linear regression analysis showed that the age of transplantation≥32 years(β=-2.52,95%CI:-3.61 to-1.21,P=0.041),graft versus⁃host disease(β=-3.25,95%CI:-6.34 to-0.21,P=0.022)and transplant complications(β=-5.93,95%CI:-9.71 to-1.24,P=0.037)were associated with poor 5⁃year life quality.Conclusions The life quality of patients with acute leukemia can be gradually improved after allogeneic hematopoietic stem cell transplantation.Actively taking measures to prevent and treat complica⁃tions after transplantation will help patients return to the life quality level of healthy people.