Günaydin Rezzan, Göksel Karatepe Altinay, Ceşmeli Nesrin, Kaya Taciser
Department of Physical Medicine and Rehabilitation, Izmir Bozyaka Training and Research Hospital, 35380 Izmir, Turkey.
Clin Rheumatol. 2009 Sep;28(9):1045-51. doi: 10.1007/s10067-009-1204-1. Epub 2009 Jun 7.
This study was designed to evaluate (a) the frequency of fatigue and its multi-dimensional nature, and (b) its association with demographic variables, disease-specific variables, and other variables, covering depression and sleep disturbance in patients with ankylosing spondylitis (AS). Sixty-two patients with AS were included in the study. Fatigue was assessed by the fatigue item of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). While the disease activity was evaluated by the BASDAI, the functional state was assessed by Bath Ankylosing Spondylitis Functional Index, metrological measurements by Bath Ankylosing Spondylitis Metrology Index, global well-being by Bath Ankylosing Spondylitis Global Score, the pain on rest by VAS (0-10 cm), sleep disturbance by Pittsburgh Sleep Quality Index, and depressive symptoms by Zung Self-Rating Depression Scale. Fifty percent of the patients had severe fatigue. Multi-dimensional assessment with MFSI-SF enabled us to identify fatigue in more detail. The disease-specific variables, covering pain, stiffness, disease activity, and physical functioning, contributed significantly with both BASDAI fatigue and MFSI-SF as dependent variables, accounting for 61.3% and 44.7% of the variance, respectively. Disease activity was the most powerful predictor of both single-dimensioned and multi-dimensioned fatigue. It was also found that the contribution of depression on fatigue was 12%. In conclusion, it was observed that half of the patients had severe fatigue, and multi-dimensional assessment was provided to understand specific aspects of fatigue better. Even though disease activity had a considerable effect on fatigue, the effects of psychogenic factors, especially depression, should be taken into consideration in the management of AS.
(a) 疲劳的频率及其多维度性质，以及 (b) 其与人口统计学变量、疾病特异性变量和其他变量的关联，这些变量涵盖强直性脊柱炎（AS）患者的抑郁和睡眠障碍。62 例 AS 患者纳入本研究。采用巴斯强直性脊柱炎疾病活动指数（BASDAI）的疲劳项目和多维疲劳症状量表简表（MFSI-SF）评估疲劳。通过 BASDAI 评估疾病活动度，通过巴斯强直性脊柱炎功能指数评估功能状态，通过巴斯强直性脊柱炎计量指数进行计量测量，通过巴斯强直性脊柱炎整体评分评估整体健康状况，通过视觉模拟评分法（0 - 10 厘米）评估静息痛，通过匹兹堡睡眠质量指数评估睡眠障碍，通过zung 自评抑郁量表评估抑郁症状。50%的患者有严重疲劳。使用 MFSI-SF 进行多维度评估使我们能够更详细地识别疲劳。以 BASDAI 疲劳和 MFSI-SF 作为因变量时，涵盖疼痛、僵硬、疾病活动度和身体功能的疾病特异性变量有显著贡献，分别占方差的 61.3%和 44.7%。疾病活动度是单维度和多维度疲劳的最有力预测因素。还发现抑郁对疲劳的贡献为 12%。总之，观察到一半的患者有严重疲劳，并提供了多维度评估以更好地了解疲劳的具体方面。尽管疾病活动度对疲劳有相当大的影响，但在 AS 的管理中应考虑心理因素尤其是抑郁的影响。
