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Kokyu to Junkan Volume 54, Issue 9 （September 2006）

呼吸と循環 54巻9号（2006年9月発行）

Japanese English

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研究

心臓の拡張機能障害患者のhealth related quality of life (新潟・佐渡心不全研究) Health-related Quality of Life in Patients with Diastolic Dysfunction: Niigata Sado Heart Failure study 大野有希子 ¹ , 大倉裕二 ¹ , Mahmoud M. Ramadan ¹ , 鈴木啓介 ² , 種田宏司 ² , 劉慧 ¹ , 石塚修 ³ , 伊藤正洋 ¹ , 加藤公則 ¹ , 塙晴雄 ¹ , 本田康征 ⁴ , 小玉誠 ¹ , 相澤義房 ¹ Yukiko Ohno ¹ , Yuji Okura ¹ , Mahmoud M. Ramadan ¹ , Keisuke Suzuki ² , Koji Taneda ² , Hui Liu ¹ , Osamu Ishizuka ³ , Masahiro Ito ¹ , Kiminori Kato ¹ , Haruo Hanawa ¹ , Masayuki Honda ⁴ , Makoto Kodama ¹ , Yoshifusa Aizawa ¹ ¹新潟大学大学院医歯学総合研究科器官制御医学講座循環器学分野 ²厚生連佐渡総合病院循環器内科 ³佐渡市立両津病院内科 ⁴本田クリニック ¹Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences ²Sado General Hospital, Sado City, Japan ³Ryotsu Hospital, Sado City, Japan ⁴Honda Clinic, Sado City, Japan キーワード：心不全 , 拡張機能障害 , 健康関連QOL , heart failure , diastolic dysfunction , health related quality of life Keyword: 心不全 , 拡張機能障害 , 健康関連QOL , heart failure , diastolic dysfunction , health related quality of life pp.1019-1026

発行日 2006年9月1日 Published Date 2006/9/1

DOI https://doi.org/10.11477/mf.1404100463

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　【目的】日本人の拡張障害(DD)患者の健康関連QOL(health related quality of life：HRQOL)について検討した．

　【方法】佐渡市の医療機関で1998年1月から2002年12月に行われた連続7,000件の心エコー検査より，DDを有す60～84歳の外来通院患者を全て抽出した．これらの患者の診療録を調査し，Medical Outcome Study Short Form36を含む質問票を郵送し回答を得た．

　【結果】 5年間で288名のDD患者が抽出された．2004年末に生存した236名へ質問票を送付し，172名(男性109名)から回答を得た．平均3.6年(中央値3.2年)の外来治療を経てもなお男女とも身体機能，全体的健康感，活力および心の健康が国民標準値と比し低下していた．これらの下位尺度の低下は運動耐容能の低下と有意に相関した．

　【結語】心身両面のHRQOLの低下はDD患者の抱える重大な問題である．その生理的背景には運動耐容能の低下があり，その改善は重要な治療目標の一つである．

Background and Purpose: Health-related quality of life(HRQOL) in Japanese patients with diastolic dysfunction(DD) is not clear. We investigated outpatients with DD on Sado Island to quantify HRQOL and identify demographic and clinical correlates of functioning.

　Methods: Outpatients with DD aged from 60 to 84 were enrolled. DD was diagnosed based on echocardiographic indicators. Patients completed a questionnaire including a 36-Item Short-Form Health Survey(SF-36) and Specific activity scale(SAS). Their medical records were also reviewed.

　Results: We have diagnosed 288 patients as having DD during the past 5 years. Two hundred and thirty-six(81.9%) have survived and were enrolled. A total of 172 patients〔male 109, age 72.8±6.7(mean±SD), female 63, age 73.2±6.9〕 completed the questionnaire. Regardless of age and gender, physical functioning(PF), general health(GH), vitality(VT) and mental health(MH) they were impaired compared with the healthy population. Exercise capacity was significantly related to all domains but body pain(BP)(r＝0.33 to 0.66, p＜0.0001). Few echocardiographic indicators or other clinical characteristics were related to these domains. Neither did the Charlson comorbidity index for predicting mortality have any relationship to these domains. DD severity, living alone and education level were also unrelated to the quality of life of DD patitent.

　Conclusions: Patients with DD have limitations across multiple domains of QOL. Among echocardiographic indicators and clinical characteristics, exercise capacity was related most closely to QOL.