Déficience, incapacité et désavantage social des patients atteints d'hépatite B chronique : une étude cas-témoins
Mots-clés :
Virologie, foie, force musculaire, spirométrie, test de terrain, qualité de vieRésumé
Introduction. Les études examinant la déficience, l’incapacité et le désavantage social des patients atteints d'hépatite virale B chronique (HVB) sont rares et présentent des conclusions contradictoires.
Objectif. Évaluer le déficit, l'incapacité et le désavantage social des patients atteints d'HVB.
Méthodes. Il s'agit d'un projet d'étude cas-témoins avec deux groupes appariés selon l'âge. Les cas (n=27) seront des patients non traités atteints d'une HVB. Les témoins (n=27) seront des participants en bonne santé. Les données suivantes seront collectées : déficit [données anthropométriques, biochimiques (fonctions rénale et hépatique, bilan lipidique, marqueurs inflammatoires), hématologiques, virologiques, de la force de préhension, et données spirométriques], incapacité [distance de marche de 6 minutes (Dm6), nombre d'arrêts, saturation de l’hémoglobine en oxygène, dyspnée (échelle-visuelle-analogique), fréquence-cardiaque, tension-artérielle] et désavantage social [questionnaires «maladie chronique du foie» et d'activité-physique]. Toute donnée spirométrique < limite-inférieure-de-la normale sera considérée comme anormale. Une force de préhension <26 kg (homme) ou <16 kg (femme) sera considérée comme basse. Les signes d'intolérance à la marche seront: arrêt pendant la marche, Dm6 ≤ limite-inférieure-de-la-normale, dyspnée en fin de la marche > 5/10, baisse de la saturation de l’hémoglobine en oxygène > 5 points, fréquence-cardiaque à la fin de la marche ≤60%. Un score total d'activité-physique < 9,42 classera le participant comme sédentaire.
Résultats attendus. Par rapport aux témoins, les cas auront une altération marquée des données aérobies sous-maximales. Ces altérations aggraveront la qualité-de-vie et peuvent être liées à des anomalies musculaires et/ou spirométriques, et soutenues par une inflammation systémique et une charge virale élevée.
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Références
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