Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia, Università La Sapienza, Rome, Italy.
Clin Exp Rheumatol. 2010 Nov-Dec;28(6 Suppl 63):S82-6. Epub 2010 Dec 22.
More than two third of patients with primary Sjögren's syndrome (SS) report fatigue. Despite its clinical relevance, only a few studies have examined the relationship of fatigue with the presence of an overlapping Fibromyalgia (FM) and other clinical and biological variables. The aim of this study was to assess the relationship between fatigue and SS disease activity and damage, FM, widespread pain, and mood disorders; finally, the possible correlation between fatigue and a panel of cytokines likely to drive the immunopathological process of the disease has been examined. Thirty-five female patients with primary SS were consecutively enrolled; for each patient the Sjögren's Syndrome Disease Damage Index (SSDDI) and the Sjögren's Syndrome Disease Activity Index (SSDAI) were calculated. Patients rated pain, fatigue and disease activity using a 100-mm VAS and completed Health Assessment Questionnaire (HAQ), the Zung depression (ZSDS) and anxiety scales (ZSAS). 30/35 patients (85.7%) felt unduly tired and the same percentage of patients suffered with pain in more than one area of the body. 7 patients satisfied ACR criteria for FM, representing 20% of the whole cohort and 23% of SS patients with fatigue. No differences were found in disease duration, SSDDI, SSDAI, ZSDS and ZSAS among SS patient with or without FM. In the whole group, fatigue VAS correlated with HAQ, ZSAS, ZSDS and pain VAS but not with age, disease duration, presence and severity of arthritis, SSDDI, SSDAI, or cytokines. In conclusion, an overlapping FM can contribute to, but does not entirely account for fatigue in Italian patients with primary SS.
超过三分之二的原发性干燥综合征 (SS) 患者报告疲劳。尽管其具有临床相关性，但只有少数研究检查了疲劳与重叠纤维肌痛 (FM) 和其他临床及生物学变量之间的关系。本研究旨在评估疲劳与 SS 疾病活动和损伤、FM、广泛疼痛和情绪障碍之间的关系；最后，还检查了疲劳与一组可能驱动疾病免疫病理过程的细胞因子之间的可能相关性。连续纳入 35 名原发性 SS 女性患者；为每位患者计算了干燥综合征疾病损伤指数 (SSDDI) 和干燥综合征疾病活动指数 (SSDAI)。患者使用 100mm VAS 评估疼痛、疲劳和疾病活动，并完成健康评估问卷 (HAQ)、zung 抑郁 (ZSDS) 和焦虑量表 (ZSAS)。35 名患者中有 30 名（85.7%）感到过度疲劳，同样比例的患者身体多个部位疼痛。7 名患者符合 ACR 纤维肌痛标准，占整个队列的 20%，占有疲劳的 SS 患者的 23%。有无 FM 的 SS 患者在疾病持续时间、SSDDI、SSDAI、ZSDS 和 ZSAS 方面无差异。在整个组中，疲劳 VAS 与 HAQ、ZSAS、ZSDS 和疼痛 VAS 相关，但与年龄、疾病持续时间、关节炎的存在和严重程度、SSDDI、SSDAI 或细胞因子无关。总之，重叠 FM 可能导致但不能完全解释意大利原发性 SS 患者的疲劳。
