类风湿关节炎和骨关节炎疲劳相关性的比较：与残疾、焦虑和睡眠障碍的关联差异。

A comparison of fatigue correlates in rheumatoid arthritis and osteoarthritis: disparity in associations with disability, anxiety and sleep disturbance.

机构信息

Department of Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, 9054, New Zealand.

出版信息

Rheumatology (Oxford). 2010 Feb;49(2):361-7. doi: 10.1093/rheumatology/kep367. Epub 2009 Dec 10.

DOI:10.1093/rheumatology/kep367

PMID:20007746

Abstract

OBJECTIVES

To investigate correlates of fatigue among individuals with RA and OA, including mood, sleep, disease activity and radiographic damage.

METHODS

Fatigue was assessed using the Multidimensional Assessment of Fatigue-Global Fatigue Index (MAF-GFI) in 103 patients with RA and 103 with OA. Sleep disturbance and pain were assessed using a visual analogue scale anxiety and depression using the Hospital Anxiety and Depression scale and disability using the HAQ. In the RA cohort, the disease activity score-28 joint count (DAS-28) and the Van der Heijde modified Sharp score were calculated, and in the OA cohort, the Kellgren-Lawrence score and the WOMAC score calculated.

RESULTS

The MAF-GFI scores were higher in the OA cohort (P = 0.02). This was not significant after controlling for disability (P = 0.59). OA participants reported greater pain, disability, depression and sleeplessness than those with RA (all P < 0.01). The strongest correlates of fatigue in the RA cohort were depression (P < 0.001) and anxiety (P < 0.001). There was no significant association with pain (P = 0.43), DAS-28 (P = 0.07), HAQ (P = 0.10) or Sharp score (P = 0.78). In OA, the correlates of fatigue were older age (P = 0.02), sleep disturbance (P = 0.03), depression (P = 0.04), disability (P = 0.04) and lower CRP (P = 0.001).

CONCLUSIONS

Fatigue is common and severe in both RA and OA. In RA, fatigue had no significant association with pain, disease activity, disability or erosions, but was associated with depression and anxiety. The disparity in correlates indicates that generalizing the experience of fatigue between OA and RA is not appropriate. Fatigue is an important domain in the assessment of disease impact.

摘要

目的

探讨类风湿关节炎（RA）和骨关节炎（OA）患者疲劳的相关因素，包括情绪、睡眠、疾病活动和放射学损伤。

方法

采用多维疲劳评估-疲劳总体指数（MAF-GFI）评估 103 例 RA 和 103 例 OA 患者的疲劳情况。采用视觉模拟评分法评估睡眠障碍和疼痛，采用医院焦虑抑郁量表评估焦虑和抑郁，采用 HAQ 评估残疾。在 RA 队列中，计算 28 关节疾病活动评分（DAS-28）和 Van der Heijde 改良 Sharp 评分，在 OA 队列中，计算 Kellgren-Lawrence 评分和 WOMAC 评分。

结果

OA 队列的 MAF-GFI 评分较高（P = 0.02）。控制残疾后，差异无统计学意义（P = 0.59）。OA 组患者的疼痛、残疾、抑郁和失眠程度均高于 RA 组（均 P < 0.01）。RA 队列中疲劳的最强相关因素是抑郁（P < 0.001）和焦虑（P < 0.001）。与疼痛无显著相关性（P = 0.43）、DAS-28（P = 0.07）、HAQ（P = 0.10）或 Sharp 评分（P = 0.78）。在 OA 中，疲劳的相关因素是年龄较大（P = 0.02）、睡眠障碍（P = 0.03）、抑郁（P = 0.04）、残疾（P = 0.04）和 CRP 较低（P = 0.001）。