日益壮大的一代老年血友病患者面临新的挑战

J. O’Hara, D. Noone, P. Kritikou, K. Myren, S. Chaplin, D. Hart
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摘要

背景:血友病患者生存率的提高意味着更多的个体有发展为年龄相关疾病的风险。在单个大型血友病人群中,不同年龄组的发病率和与健康相关的生活质量(HRQoL)知之甚少。目的:本研究旨在探讨血友病患者年龄增长与合并症之间的关系,并将他们的HRQoL与英国普通人群的HRQoL进行比较。方法比较欧洲血友病成本:欧洲社会经济调查研究(CHESS)中各年龄组参与者病历中记录的合并症患病率和EQ-5D评估的HRQoL。将HRQoL与2012年英格兰健康调查(HSE)中抽取的普通人群样本进行比较。结果国际象棋组的年轻人更有可能从早期开始接受预防。年轻人平均受影响的关节数为1.0个;41-50岁(1.25)和51-60岁(1.41)的参与者平均受影响的关节数量最多。18-30岁患者共病发生率为36%,31 - 60岁患者为61%,61岁以上患者为68%。年轻血友病患者的HRQoL损害与60岁以上HSE人群相当。结论:与年轻人相比,老年血友病患者的生活质量受损,并且几种影响心理健康、心血管和骨骼健康的年龄相关疾病的患病率增加。患有血友病的年轻成年人报告的HRQoL受损与61岁以上的普通人群相当。
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New challenges for an expanding generation of older persons with haemophilia
Abstract Background Increasing survival among people with haemophilia means that more individuals are at risk of developing age-related morbidity. Little is known about morbidity and health-related quality of life (HRQoL) in different age groups within a single large population of people with haemophilia. Aim This study aimed to explore the association between increasing age and comorbidity among people with haemophilia and to compare their HRQoL with that of a sample of the general population in England. Methods The prevalence of comorbidity recorded in medical records and HRQoL assessed by EQ-5D were compared by age group in participants in the Cost of Haemophilia in Europe: A Socioeconomic Survey study (CHESS) in Europe. HRQoL was compared with that of a sample of the general population taken from the 2012 Health Survey for England (HSE). Results Younger adults in CHESS were more likely to have received prophylaxis from an early age. The mean number of affected joints in younger adults was 1.0; participants aged 41–50 (1.25) and 51–60 years (1.41) had the highest mean number of affected joints. The prevalence of comorbidity was 36% in patients aged 18–30, 61% in 31–60-year-olds and 68% in those aged 61+. HRQoL impairment in young adults with haemophilia was comparable with that in the HSE population aged over 60. Conclusions Older people with haemophilia have impaired quality of life compared with younger adults and an increasing prevalence of several age-related disorders affecting mental health and cardiovascular and bone health. Young adults with haemophilia report impaired HRQoL comparable with that in a general population aged 61+.
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