中等剂量三级预防对成人重度/中度血友病A患者生活质量和心理方面的影响

IF 2 4区 医学 Q3 HEMATOLOGY Hematology Pub Date : 2025-12-01 Epub Date: 2025-01-12 DOI:10.1080/16078454.2024.2439061
Hua Gao, Jia Liu, Shiqiu Zhou, Jing Gao, Jing Tan, Rong Chen
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引用次数: 0

摘要

目的:中剂量三级预防是否能改善重度/中度 A 型血友病成人患者的生活质量和心理健康,目前尚未确定。本研究旨在探讨使用重组人 FVIII(rhFVIII)进行中间剂量三级预防对按需治疗过渡患者的生活质量、焦虑和抑郁的影响:这项回顾性分析收集了 2019 年 7 月至 2022 年 7 月期间的数据。比较了预防前后的成人血友病生活质量问卷(HAEMO-QoL-A)、患者健康问卷-9(PHQ-9)和广泛性焦虑症-7(GAD-7)。此外,还分析了 3 年预防期结束时的功能独立性和关节状况,以及它们与 HAEMO-QoL-A、PHQ-9 和 GAD-7 的相关性:预防后 HAEMO-QoL-A 总分下降(预防前:88.90 ± 33.38 vs. 预防后:79.59 ± 22.89)(P = 0.016)。预防前和预防后的 PHQ-9 平均得分分别为 4.44 ± 4.63 和 5.56 ± 4.30(P = 0.058),而 GAD-7 平均得分分别为 3.15 ± 3.84 和 4.44 ± 3.99(P = 0.016)。HAEMO-QoL-A与功能独立性有显著相关性(P = 0.032),PHQ-9评分与膝关节康复评分有显著相关性(P = 0.047),GAD-7评分与治疗经验和踝关节康复评分有显著相关性(P = 0.029,P = 0.039):结论:使用rhFVIII进行中剂量三级预防可改善重度/中度A型血友病成人患者的生活质量,但不能缓解焦虑和抑郁。步态和年龄也会在一定程度上影响生活质量。我们需要进行焦虑和抑郁筛查,并在必要时提供心理治疗。
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Impact of intermediate-dose tertiary prophylaxis on quality of life and psychological aspects of adult patients with severe/moderate hemophilia A.

Objectives: Whether intermediate-dose tertiary prophylaxis can improve quality of life and psychological health in adults with severe/moderate hemophilia A has not been determined. This research aims to explore the impact of intermediate-dose tertiary prophylaxis with recombinant human FVIII (rhFVIII) on quality of life, anxiety and depression in such individuals transitioned from on-demand treatment.

Methods: This retrospective analysis collected data from July 2019 to July 2022. Haemophilia Quality of Life Questionnaire for Adults (HAEMO-QoL-A), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) were compared before and after prophylaxis. Additionally, functional independence and joint status were analyzed at the end of the 3-year prophylaxis period, as well as their correlations with HAEMO-QoL-A, PHQ-9, and GAD-7.

Results: The HAEMO-QoL-A total score decreased after prophylaxis (pre-prophylaxis: 88.90 ± 33.38 vs. post-prophylaxis: 79.59 ± 22.89) (P = 0.016). The mean PHQ-9 scores before and after prophylaxis were 4.44 ± 4.63 and 5.56 ± 4.30 (P = 0.058), respectively, while the mean GAD-7 scores were 3.15 ± 3.84 and 4.44 ± 3.99 (P = 0.016). Significant correlations were observed for HAEMO-QoL-A with functional independence (P < 0.001), mood and emotions with age (P = 0.032), PHQ-9 scores with knee joint rehabilitation scores (P = 0.047), and GAD-7 scores with treatment experience and ankle joint rehabilitation scores (P = 0.029, P = 0.039).

Conclusion: Intermediate-dose tertiary prophylaxis with rhFVIII can improve quality of life but not relieve anxiety and depression in adults with severe/moderate hemophilia A. Better functional independence correlates with improved quality of life. Gait and age also influence the quality of life to some extent. We need to undertake anxiety and depression screening and provide psychological treatment when necessary.

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来源期刊
Hematology
Hematology 医学-血液学
CiteScore
2.60
自引率
5.30%
发文量
140
审稿时长
3 months
期刊介绍: Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.
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