Georges C, Chassany O, Toledano C, Mouthon L, Tiev K, Meyer O, Ilie D, Rambeloarisoa J, Marjanovic Z, Cabane J, Sereni D, Pouchot J, Farge D
Internal Medicine Department, Saint Louis Hospital, Service de Médecine Interne, Hôpital Saint Louis, 1 avenue Claude Vellefaux, 75010 Paris, France.
Rheumatology (Oxford). 2006 Oct;45(10):1298-302. doi: 10.1093/rheumatology/kel189. Epub 2006 Jun 4.
Systemic sclerosis (SSc) has an heterogenous clinical pattern, with variable organ involvement and degrees of severity. Like in other rheumatic diseases, the self-questionnaires have been used to evaluate SSc globally. The aim of the study is as to evaluate the quality of life (QoL) in patients with either diffuse or limited SSc, and to examine the impact of pain on the QoL scores.
Patients with SSc, either diffuse or limited SSc, were included in a cross-sectional study. The QoL was evaluated with the short-form 36 (SF-36) and the functional repercussion with the SSc-modified Health Assessment Questionnaire (S-HAQ).
A total of 89 patients (67 with diffuse and 22 with limited SSc) were included. The SF-36 score values were lower in SSc patients than those reported in the general population. The physical component scores (PCS) of the SF-36 was significantly worse in diffuse compared with limited SSc (P < 0.05). The PCS was significantly negatively related to the number of clinical manifestations (ANOVA, P < 0.0001). The mental component score (MCS) was not influenced by the type of SSc or the number of clinical manifestations presented by the patient. The QoL of SSc patients was highly correlated with pain (R = 0.69) and disability (R = 0.70). Interestingly, the QoL of SSc patients was only slightly correlated with cutaneous (R = 0.42) and pulmonary involvement (R = 0.57).
The QoL of patients with SSc is strongly influenced by the type of SSc, the burden of clinical manifestations, the functional disability and by the pain, whatever its cause. The treatment of pain should be considered as priority to improve the QoL of SSc patients.
系统性硬化症（SSc）具有异质性临床模式，器官受累情况和严重程度各不相同。与其他风湿性疾病一样，自我问卷调查已被用于全面评估SSc。本研究的目的是评估弥漫性或局限性SSc患者的生活质量（QoL），并探讨疼痛对QoL评分的影响。
弥漫性或局限性SSc患者纳入一项横断面研究。采用简明健康调查问卷36项（SF-36）评估QoL，采用SSc改良健康评估问卷（S-HAQ）评估功能影响。
共纳入89例患者（67例弥漫性SSc和22例局限性SSc）。SSc患者的SF-36评分值低于一般人群报告的值。与局限性SSc相比，弥漫性SSc患者的SF-36身体成分评分（PCS）明显更差（P<0.05）。PCS与临床表现数量显著负相关（方差分析，P<0.0001）。精神成分评分（MCS）不受SSc类型或患者临床表现数量的影响。SSc患者的QoL与疼痛（R=0.69）和残疾（R=0.70）高度相关。有趣的是，SSc患者的QoL与皮肤受累（R=0.42）和肺部受累（R=0.57）仅略有相关。
无论病因如何，SSc患者的QoL受到SSc类型、临床表现负担、功能残疾和疼痛的强烈影响。应将疼痛治疗作为改善SSc患者QoL的优先事项。
