Marcus Seth B, Strople Jennifer A, Neighbors Katie, Weissberg-Benchell Jill, Nelson Suzanne P, Limbers Christine, Varni James W, Alonso Estella M
Department of Pediatrics, Northwestern University, Chicago, Illinois 60614, USA.
Clin Gastroenterol Hepatol. 2009 May;7(5):554-61. doi: 10.1016/j.cgh.2009.01.022.
BACKGROUND & AIMS: Fatigue profoundly impacts quality of life and is a common complaint among patients with chronic disease. This study examined the degree of fatigue and health-related quality of life (HRQOL) in children with inflammatory bowel disease (IBD).
Seventy children with IBD and 157 healthy controls and their parents completed age-appropriate measures of fatigue (PedsQL Multidimensional Fatigue Scale) and HRQOL (PedsQL 4.0 Generic Core Scales). Children with IBD completed the IMPACT III Quality of Life Questionnaire, and the Children's Depression Inventory: Short form was completed by children with IBD and healthy controls. Disease activity was determined according to the diagnosis with either the Pediatric Crohn's Disease Activity Index (PCDAI) or a Physician's Global Assessment.
Children with Crohn's disease (N = 52) had a median PCDAI of 0, and 56% with ulcerative colitis (N = 13) or indeterminate colitis (N = 5) were in remission. Mean child self-report PedsQL Multidimensional Fatigue Total Scale scores were 73.9 +/- 16.8 and 82.2 +/- 12.3 for patients with IBD and controls, respectively (P < .001). Mean child self-report PedsQL 4.0 Generic Core Total Scale scores were 76.7 +/- 14.2 and 85.9 +/- 10.4 for patients with IBD and controls, respectively (P < .0001). Children with IBD did not self-report statistically different mean total fatigue and subscale scores compared with children with rheumatologic diseases or cancer.
In children with primarily inactive IBD, fatigue was significantly higher and HRQOL was significantly lower than in healthy controls. Results among children with IBD were comparable to children with rheumatologic diseases and cancer.
疲劳对生活质量有深远影响,是慢性病患者常见的主诉。本研究调查了炎症性肠病(IBD)患儿的疲劳程度及健康相关生活质量(HRQOL)。
70例IBD患儿、157例健康对照儿童及其父母完成了适合其年龄的疲劳测量(儿童生活质量量表多维疲劳量表)和HRQOL测量(儿童生活质量量表4.0通用核心量表)。IBD患儿完成了炎症性肠病生活质量问卷(IMPACT III),IBD患儿和健康对照儿童完成了儿童抑郁量表简版。根据儿科克罗恩病活动指数(PCDAI)诊断或医生整体评估确定疾病活动度。
克罗恩病患儿(N = 52)的PCDAI中位数为0,溃疡性结肠炎患儿(N = 13)或未定型结肠炎患儿(N = 5)中有56%处于缓解期。IBD患儿和对照儿童的儿童自我报告儿童生活质量量表多维疲劳总量表平均得分分别为73.9±16.8和82.2±12.3(P <.001)。IBD患儿和对照儿童的儿童自我报告儿童生活质量量表4.0通用核心总量表平均得分分别为76.7±14.2和85.9±10.4(P <.0001)。与风湿性疾病或癌症患儿相比,IBD患儿自我报告的平均总疲劳得分和分量表得分在统计学上无显著差异。
在主要处于非活动期的IBD患儿中,疲劳程度显著高于健康对照儿童,HRQOL显著低于健康对照儿童。IBD患儿的结果与风湿性疾病和癌症患儿相当。