疲劳与慢性乙型肝炎生活在北美的患者

StephenW

Original Article

Digestive Diseases and Sciences

April 2016, Volume 61, Issue 4, pp 1186-1196

First online: 30 January 2016
Fatigue in Patients with Chronic Hepatitis B Living in North America: Results from the Hepatitis B Research Network (HBRN)

    Donna M. Evon , Abdus S. Wahed, Geoffrey Johnson, Mandana Khalili, Mauricio Lisker-Melman, Robert J. Fontana, Souvik Sarkar, Bryce B. Reeve, Jay H. Hoofnagle


Abstract
Background

Fatigue is a common symptom of liver disease but not well characterized in patients with chronic hepatitis B virus (HBV).
Aims

We assessed the rate of fatigue using a validated instrument in patients with HBV and identified demographic, virologic, and clinical features associated with fatigue in a cross-sectional cohort study from the Hepatitis B Research Network.
Methods

Participants were English- and Spanish-speaking adults with chronic HBV who were not pregnant nor on treatment. Fatigue was measured using the PROMIS® Fatigue 7-item Short Form.
Results

The sample included 948 adults: median age 42; 51 % female; 71 % Asian; 74 % college educated; 77 % employed; 41 % inactive HBV carriers; 36 % with active chronic disease; and 2 % with advanced fibrosis, defined as AST–platelet ratio index (APRI) > 1.50. Patients with chronic HBV had a mean fatigue T-score of 46.8 ± SD = 7.9, compared to a mean fatigue T-score of 50.0 ± 10 in the US general population (p < .0001). In univariate analyses, greater fatigue was associated with demographic and clinical features such as female sex, lower income, more comorbidities, higher APRI score, and poorer mental health (p < 0.05). In multivariate analysis, female sex (p < .001), poorer mental health (p < .001), APRI score (p = .005), and history of diabetes (p = .039) were the strongest independent predictors.
Conclusions

The frequency of fatigue in this large cohort of North American chronic HBV patients may be equal to or lower than that reported in the US general population. Patients with advanced fibrosis, more comorbidities, and poorer mental health report worse fatigue.
Keywords
Liver Mental health Patient-reported outcomes PROMIS Symptoms

For the Hepatitis B Research Network (HBRN).

StephenW

原始文章
消化道疾病与科学
2016年4月，卷61，第4期，第1186至1196年
首先在线：2016年1月30日
疲劳与慢性乙型肝炎生活在北美的患者：从乙型肝炎研究网络（PBRN）唐娜M. Evon，阿卜杜勒·瓦希德S.，杰弗里·约翰逊，Mandana哈利利，毛Lisker - 梅尔曼，罗伯特·丰塔纳，Souvik萨卡结果，布莱斯B.里夫，周杰伦H.胡夫纳格尔
抽象
背景
疲劳是肝脏疾病的一种常见的症状，但不能很好地表征在慢性​​乙型肝炎病毒（HBV）。
目标
我们患者的乙肝病毒，并确定了人口，病毒学和疲劳从乙型肝炎研究网络的断面队列研究相关的临床特征使用经过验证的工具评估疲劳的速度。
方法
与会者英语和讲西班牙语的成人慢性乙肝谁没有怀孕，也没有治疗。疲劳是使用PROMIS®疲劳7项短表测量。
结果
样本包括948位：中位年龄42; 51％为女性; 71％亚洲; 74％的大专以上学历; 77％的就业; 41％的非活动乙肝病毒携带者; 36％的活动性慢性疾病的;和2％的晚期肝纤维化，定义为AST-血小板比率指数（APRI）> 1.50。慢性HBV有46.8±SD = 7.9的平均疲劳T分，相比50.0±10在美国总人口中平均疲劳T值（P <0.0001）。在单变量分析，更大的疲劳与人口学和临床特征，如女性，收入较低，合并症更多，更高的分数APRI和较差的心理健康（P <0.05）有关。多变量分析显示，女性（P <0.001），较差的心理健康（P <0.001），APRI评分（P = 0.005）和糖尿病史（P = .039）是最强的独立预测因子。
结论
疲劳在此大型队列北美慢性HBV患者的频率可能比在美国总人口报告等于或更低。患者晚期肝纤维化，更多的合并症和较差的心理健康调查报告更糟糕的疲劳。
关键词
肝心理健康病人报告结果PROMIS症状
对于乙肝研究网络（HBRN）。

君看一叶舟

仅靠“乏力”这一症状，无法确定是否肝炎引起。

Newbegin

有意思的文章，谢谢分享！