Öz
Amaç:
Granülomatozis polianjit (GPA), anti-nötrofil sitoplazmik antikor ile ilişkili küçük damar vaskülitleri grubunda yer alan otoimmün bir hastalıktır ve tedavi edilmediği takdirde önemli morbidite ve mortalite ile ilişkilidir. Bu çalışmada, GPA hastalarının sağlıkla ilişkili yaşam kalitesindeki (HRQoL) bozulmayı değerlendirmeyi ve HRQoL’yi etkileyebilecek olası faktörleri belirlemeyi amaçladık.
Yöntem:
American College of Rheumatology 1990 GPA sınıflandırması kriterlerini karşılayan kırk hasta çalışmaya dahil edildi. Sağlıklı gönüllülerden benzer yaş ve cinsiyet özelliklerine sahip kontrol grubu oluşturuldu. Hastaların demografik bilgileri, hastalık özellikleri ve tedavileri kaydedildi. HRQoL’yi değerlendirmek için Medical Outcomes Study Short-Form 36 (SF-36) Türkçe versiyonu kullanıldı. GPA’ya ve/veya tedavisine atfedilebilen geri dönüşümsüz organ hasarı, vaskülit hasar indeksi (VDI) kullanılarak değerlendirildi.
Bulgular:
Kontrol grubu ile karşılaştırıldığında, GPA hastalarında SF-36 8 alt ölçek bileşeninden biri olan ruh sağlığı dışındaki tüm SF-36 alanları anlamlı olarak bozulmuştu. Farklı SF-36 puanları ile toplam VDI skoru, etkilenen organ sistemi, hastalık süresi veya total steroid dozu arasında anlamlı bir ilişki yoktu. Toplam rituksimab dozu ile yalnızca genel sağlık ve duygusal rol arasında negatif bir korelasyon gözlendi.
Sonuç:
Hastalık aktivitesinden bağımsız olarak, GPA ile izlenen hastalarda HRQoL’de anlamlı azalma gözlenmektedir. GPA yönetimindeki ilerlemelere rağmen, sonuçlarımız HRQoL’deki bozulmanın hala bir sorun olduğunu göstermektedir. Ayrıca, rituksimab tedavisi bozulmuş HRQoL’nin göstergesi olabilir.
Anahtar Kelimeler: Granulomatöz polianjit, yaşam kalitesi, kısa-form 36, vaskülit hasar indeksi, rituksimab
Kaynakça
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