Mayoux-Benhamou M-A
Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Institut de Rhumatologie, Hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
Ann Readapt Med Phys. 2006 Jul;49(6):301-4, 385-8. doi: 10.1016/j.annrmp.2006.04.011. Epub 2006 Apr 25.
Fatigue is a common complaint among patients with rheumatoid arthritis (RA) and is regarded as an extra-articular symptom of the disease. Little attention has been paid by health professional teams to the multidimensional nature of RA-related fatigue and its wide-ranging consequences for quality of life. Unlike normal tiredness, fatigue is chronic, typically not related to overexertion and poorly relieved by rest. The prevalence is high and several RA-related components have been reported as predictors of fatigue. RA-related fatigue appeared to be strongly associated with psychosocial factors. Fatigue assessment and management are complex because psychological and physiological factors may be involved. Several instruments that have been used in RA to assess fatigue. They have involved a self-reporting format. Some are brief, quantitative and symptom-focused questionnaires. Others provide a multidimensional assessment. DMARD therapy, especially anti-TNF decreased disease activity and alleviates fatigue. An additional direct effect is hypothetical. The non-pharmacological management includes behavioral therapy or self-management courses and physical exercise. Finally, the importance and relevance of fatigue as an outcome measure is becoming highlighted by research groups and should lead to improved management of fatigue in usual medical practice.
疲劳是类风湿关节炎（RA）患者的常见主诉，被视为该疾病的关节外症状。医疗专业团队对RA相关疲劳的多维度性质及其对生活质量的广泛影响关注甚少。与正常疲劳不同，RA相关疲劳是慢性的，通常与过度劳累无关，休息也难以有效缓解。其患病率很高，一些与RA相关的因素已被报道为疲劳的预测指标。RA相关疲劳似乎与心理社会因素密切相关。由于可能涉及心理和生理因素，疲劳的评估和管理很复杂。在RA中已使用多种工具来评估疲劳。这些工具采用自我报告形式。有些是简短的、定量的且以症状为重点的问卷。其他则提供多维度评估。改善病情抗风湿药（DMARD）治疗，尤其是抗TNF治疗，可降低疾病活动度并减轻疲劳。还有一种假设的直接作用。非药物管理包括行为疗法或自我管理课程以及体育锻炼。最后，研究小组越来越强调疲劳作为一项结局指标的重要性和相关性，这应该会促使在日常医疗实践中改善对疲劳的管理。
