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[多发性硬化症中慢性疲劳的重要性及相关因素]

[Importance and factors related to chronic fatigue in multiple sclerosis].

作者信息

Alarcia R, Ara J R, Martín J, Bertol V, Bestué M

机构信息

Unidad de Enfermedades Desmielinizantes, Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza.

出版信息

Neurologia. 2005 Mar;20(2):77-84.

Abstract

INTRODUCTION

The importance of fatigue in multiple sclerosis (MS) is determined by its high frequency and it is an important cause of disability.

OBJECTIVE

To determine factors that are related to the presence of chronic fatigue in patients with MS.

PATIENTS AND METHODS

The series comprises patients with MS, consecutively attended in the demyelinizating diseases unit, who met the following criteria: clinically definite MS (RR or SP), MS duration of more than two years, and no relapses during the previous month. Analyzed variables were as follows: chronic fatigue, demographic data, functional systems, EDSS, ISS, ESS, disease activity, Hamilton, depression scale GHQ-28, PSQI, and interferon. Statistical study: bivariate and multivariate analysis by logistic regression.

RESULTS

A hundred patients were included, 72 female and 28 male. Mean age was 39.27 years. Of the 100 patients 88 had RR disease and 12 SP disease. MS mean duration was 11.2 years. Mean EDSS 2.54. Chronic fatigue was 53 %. The presence of depression increased the probability of chronic fatigue 3.6 fold, and every point in PSQI-7 increases it 3.5 fold.

CONCLUSION

Depression and the PSQI-7 subscale (day sleep dysfunction) are the only variables independently related to chronic fatigue in patients with MS.

摘要

引言

疲劳在多发性硬化症(MS)中十分重要,因其出现频率高,是导致残疾的重要原因。

目的

确定与MS患者慢性疲劳存在相关的因素。

患者与方法

该系列研究对象为在脱髓鞘疾病科连续就诊的MS患者,他们需符合以下标准:临床确诊为MS(复发缓解型或继发进展型),MS病程超过两年,且前一个月无复发。分析的变量如下:慢性疲劳、人口统计学数据、功能系统、扩展残疾状态量表(EDSS)、国际睡眠障碍分类(ISS)、爱泼沃斯思睡量表(ESS)、疾病活动度、汉密尔顿抑郁量表、一般健康问卷-28(GHQ-28)、匹兹堡睡眠质量指数(PSQI)以及干扰素。统计研究:采用逻辑回归进行双变量和多变量分析。

结果

共纳入100例患者,其中女性72例,男性28例。平均年龄为39.27岁。100例患者中,88例为复发缓解型疾病,12例为继发进展型疾病。MS平均病程为11.2年。平均EDSS为2.54。慢性疲劳发生率为53%。抑郁的存在使慢性疲劳的发生概率增加3.6倍,PSQI-7每增加一分,慢性疲劳发生概率增加3.5倍。

结论

抑郁和PSQI-7分量表(日间睡眠功能障碍)是仅有的与MS患者慢性疲劳独立相关的变量。

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