Ng A K, Li S, Recklitis C, Neuberg D, Chakrabarti S, Silver B, Diller L
Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, USA.
Ann Oncol. 2005 Dec;16(12):1949-55. doi: 10.1093/annonc/mdi407. Epub 2005 Oct 14.
To compare the level of fatigue in survivors of Hodgkin's disease and their siblings, and to explore factors associated with increased fatigue.
Survivors of Hodgkin's disease 5 years or more from diagnosis and their siblings completed a questionnaire study. Fatigue level was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) instrument, with lower scores reflecting increased fatigue. Multiple regression models were used to identify factors associated with fatigue level in the two populations.
Five hundred and eleven survivors (median age 44 years; range 16-82) and 224 siblings (median age 44 years; range 16-79) returned the completed questionnaire. The response rates were 61% and 58%, respectively. Compared with siblings, survivors were significantly more likely to report the presence of cardiac disease (26% versus 16%; P = 0.001) and hypothyroidism (65% versus 3%; P <0.001), and had a significantly lower mean FACIT-F score (40.7 and 42.2; P = 0.05). On multivariable analysis, factors significantly associated with increased fatigue in survivors were reports of cardiac disease (P <0.001), psychiatric condition (P <0.001), history of tobacco use (P = 0.004) and low exercise frequency (P = 0.03). For siblings, the only independent factor associated with increased fatigue was low exercise frequency (P = 0.03).
Survivors of Hodgkin's disease were more fatigued than their siblings. The difference was modest but statistically significant. The significant association between fatigue and cardiac disease suggests the importance of screening for underlying cardiac dysfunction in survivors with symptoms of fatigue. The association between fatigue and smoking history may be due to exacerbation of late medical complications of Hodgkin's disease by tobacco use.
比较霍奇金淋巴瘤幸存者及其同胞的疲劳程度，并探讨与疲劳加剧相关的因素。
自确诊起5年及以上的霍奇金淋巴瘤幸存者及其同胞完成了一项问卷调查研究。使用慢性病治疗功能评估-疲劳（FACIT-F）工具测量疲劳程度，得分越低表明疲劳加剧。采用多元回归模型确定这两个人群中与疲劳程度相关的因素。
511名幸存者（中位年龄44岁；范围16 - 82岁）和224名同胞（中位年龄44岁；范围16 - 79岁）返回了完整的问卷。回复率分别为61%和58%。与同胞相比，幸存者更有可能报告患有心脏病（26%对16%；P = 0.001）和甲状腺功能减退（65%对3%；P <0.001），且FACIT-F平均得分显著更低（40.7和42.2；P = 0.05）。多变量分析显示，与幸存者疲劳加剧显著相关的因素包括心脏病报告（P <0.001）、精神疾病（P <0.001）、吸烟史（P = 0.004）和低运动频率（P = 0.03）。对于同胞而言，与疲劳加剧相关的唯一独立因素是低运动频率（P = 0.03）。
霍奇金淋巴瘤幸存者比其同胞更易疲劳。这种差异虽小但具有统计学意义。疲劳与心脏病之间的显著关联表明，对有疲劳症状的幸存者筛查潜在心脏功能障碍具有重要意义。疲劳与吸烟史之间的关联可能是由于吸烟加剧了霍奇金淋巴瘤的晚期医学并发症。
