An investigation of quality of life and treatment of patients with primary biliary cholangitis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo evaluate the quality of life and treatment of patients with primary biliary cholangitis (PBC) using the PBC-40 scale. MethodsThe PBC-40 scale was used to perform an investigation of 37 patients who were diagnosed with PBC and received continuous treatment in Department of Gastroenterology, The First Affiliated Hospital of Air Force Medical University, from January 2017 to December 2018. With reference to patients’ baseline biochemical parameters and pathological staging, the scores of the six domains of the PBC-40 scale, i.e., “symptom”, “pruritus”, “weakness”, “cognitive function”, “social function”, and “emotional function”, were analyzed. The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and an analysis of variance was used for comparison between multiple groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups. The paired-samples Wilcoxon signed rank sum test was used for comparison of pruritus score before and after treatment, and the paired samples t-test was used for comparison of weakness score before and after treatment. A Spearman analysis was used to investigate correlation. ResultsIn the PBC-40 scale, the scores of symptom, pruritus, weakness, cognitive function, social function, and emotional function were 16.5±4.3, 5.2±3.3, 26.4±8.3, 15.3±5.1, 25.4±8.4, and 8.1±2.7, respectively. A stratified analysis was performed for the patients aged ＜50 years, 50-60 years, and ＞60 years, and the results showed that there was a significant difference in the score of pruritus between the different age groups (χ2=8.290, P=0.016). The PBC patients with a body mass index of ≥24 kg/m2 had significantly lower scores of symptom and cognitive function than those with a body mass index of ＜24 kg/m2 (symptom Z=-2.222, P=0025; cognitive function t=2.255, P=0.030). The patients with positive anticentromere antibody had a significantly higher score of weakness than those with negative anticentromere antibody (t=3.453, P=0.001). The score of pruritus was positively correlated with alkaline phosphatase (ALP) (R2=0.325, P=0.049) and gamma-glutamyl transpeptidase (GGT) (R2=0.402, P=0.014). ConclusionThe PBC-40 scale can be used to evaluate the quality of life of Chinese patients with PBC. High levels of ALP and GGT may predict low quality of life.