Cleveland Clinic, Cleveland, OH 44195, USA.
Arthritis Care Res (Hoboken). 2011 Jun;63(6):827-33. doi: 10.1002/acr.20442.
To assess the frequency of fibromyalgia syndrome (FMS), depression, and sleep disorders in patients with granulomatosis with polyangiitis (Wegener's) (GPA).
The London Fibromyalgia Epidemiologic Study Screening Questionnaire (LFESSQ), Symptom Intensity Scale, Epworth Sleepiness Scale (ESS), and the Brief Patient Health Questionnaire-9 (BPHQ-9) were administered prospectively to patients who met the American College of Rheumatology criteria for GPA. Fatigue was captured quantitatively by the fatigue visual analog scale (VAS) and qualitatively by the LFESSQ fatigue questionnaire. Disease activity and damage were captured by using the Birmingham Vasculitis Activity Score for GPA (BVAS/GPA) and the Vasculitis Damage Index (VDI). Frequency of FMS and depression in GPA was compared with the general population.
Patients with GPA have significantly greater frequency of FMS (LFESSQ 23.6 versus 13; P = 0.02) and depression (22% versus 7.6%; P < 0.001) than the general population. Twenty-nine percent of GPA patients had sleep abnormalities according to ESS scores of ≥10; 76.4% reported fatigue and 49.1% indicated that fatigue significantly limited their activities. There was no correlation between BPHQ-9, ESS, LFESSQ, fatigue VAS, and VDI, BVAS/GPA, or disease duration. There was a strong correlation between fatigue VAS and BPHQ-9 (r = 0.73; 95% confidence interval [95% CI] 0.54, 0.92). The correlation between fatigue VAS and ESS was significant but not as strong as with the BPHQ-9 (r = 0.36; 95% CI 0.10, 0.62).
FMS and depression occur more often in GPA compared with the general population. The association is not related to disease activity, damage, or disease duration. Fatigue is very common and significantly limits normal daily activities. Depression and sleep disorders contribute to fatigue in GPA patients.
评估纤维肌痛综合征（FMS）、抑郁和睡眠障碍在肉芽肿性多血管炎（韦格纳氏）（GPA）患者中的发生频率。
前瞻性地向符合美国风湿病学会 GPA 标准的患者发放伦敦纤维肌痛症流行病学研究筛查问卷（LFESSQ）、症状严重程度量表、Epworth 嗜睡量表（ESS）和简短患者健康问卷-9（BPHQ-9）。疲劳通过疲劳视觉模拟量表（VAS）进行定量评估，通过 LFESSQ 疲劳问卷进行定性评估。采用 GPA 伯明翰血管炎活动评分（BVAS/GPA）和血管炎损伤指数（VDI）评估疾病活动度和损伤。比较 GPA 患者中 FMS 和抑郁的发生率与一般人群。
与一般人群相比，GPA 患者的 FMS（LFESSQ 23.6 比 13；P = 0.02）和抑郁（22%比 7.6%；P < 0.001）发生率显著更高。根据 ESS 评分≥10，29%的 GPA 患者存在睡眠异常；76.4%的患者报告疲劳，49.1%的患者表示疲劳显著限制了他们的活动。BPHQ-9、ESS、LFESSQ、疲劳 VAS 和 VDI、BVAS/GPA 或疾病持续时间之间无相关性。疲劳 VAS 与 BPHQ-9 之间呈强相关性（r = 0.73；95%置信区间[95%CI]0.54，0.92）。疲劳 VAS 与 ESS 之间的相关性虽然显著，但不如与 BPHQ-9 的相关性强（r = 0.36；95%CI 0.10，0.62）。
与一般人群相比，GPA 中 FMS 和抑郁更为常见。这种关联与疾病活动度、损伤或疾病持续时间无关。疲劳非常常见，严重限制了正常的日常活动。抑郁和睡眠障碍导致 GPA 患者疲劳。
