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系统性硬化症患者的性别与临床表现、生活质量、残疾以及抑郁和焦虑的相关性。

Association of gender with clinical expression, quality of life, disability, and depression and anxiety in patients with systemic sclerosis.

机构信息

Université Paris Descartes, Faculté de Médecine Paris Descartes, Pôle de Médecine Interne, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France.

出版信息

PLoS One. 2011 Mar 9;6(3):e17551. doi: 10.1371/journal.pone.0017551.

Abstract

OBJECTIVES

To assess the association of gender with clinical expression, health-related quality of life (HRQoL), disability, and self-reported symptoms of depression and anxiety in patients with systemic sclerosis (SSc).

METHODS

SSc patients fulfilling the American College of Rheumatology and/or the Leroy and Medsger criteria were assessed for clinical symptoms, disability, HRQoL, self-reported symptoms of depression and anxiety by specific measurement scales.

RESULTS

Overall, 381 SSc patients (62 males) were included. Mean age and disease duration at the time of evaluation were 55.9 (13.3) and 9.5 (7.8) years, respectively. One-hundred-and-forty-nine (40.4%) patients had diffuse cutaneous SSc (dcSSc). On bivariate analysis, differences were observed between males and females for clinical symptoms and self-reported symptoms of depression and anxiety, however without reaching statistical significance. Indeed, a trend was found for higher body mass index (BMI) (25.0 [4.1] vs 23.0 [4.5], p = 0.013), more frequent dcSSc, echocardiography systolic pulmonary artery pressure >35 mmHg and interstitial lung disease in males than females (54.8% vs 37.2%, p = 0.010; 24.2% vs 10.5%, p = 0.003; and 54.8% vs 41.2%, p = 0.048, respectively), whereas calcinosis and self-reported anxiety symptoms tended to be more frequent in females than males (36.0% vs 21.4%, p = 0.036, and 62.3% vs 43.5%, p = 0.006, respectively). On multivariate analysis, BMI, echocardiography PAP>35 mmHg, and anxiety were the variables most closely associated with gender.

CONCLUSIONS

In SSc patients, male gender tends to be associated with diffuse disease and female gender with calcinosis and self-reported symptoms of anxiety. Disease-associated disability and HRQoL were similar in both groups.

摘要

目的

评估性别与系统性硬化症(SSc)患者的临床表现、健康相关生活质量(HRQoL)、残疾以及抑郁和焦虑的自我报告症状之间的关联。

方法

评估符合美国风湿病学会和/或 Leroy 和 Medsger 标准的 SSc 患者的临床症状、残疾、HRQoL、抑郁和焦虑的自我报告症状,采用特定的测量量表进行评估。

结果

共纳入 381 名 SSc 患者(62 名男性)。评估时的平均年龄和病程分别为 55.9(13.3)岁和 9.5(7.8)年。149 名(40.4%)患者为弥漫性皮肤型 SSc(dcSSc)。在单变量分析中,男性和女性在临床症状和抑郁及焦虑的自我报告症状方面存在差异,但无统计学意义。事实上,男性的体重指数(BMI)更高(25.0[4.1]比 23.0[4.5],p=0.013)、弥漫性疾病更常见、超声心动图收缩期肺动脉压>35mmHg 和间质性肺病的发生率高于女性(54.8%比 37.2%,p=0.010;24.2%比 10.5%,p=0.003;54.8%比 41.2%,p=0.048),而女性钙沉积和自我报告的焦虑症状更常见(36.0%比 21.4%,p=0.036;62.3%比 43.5%,p=0.006)。多变量分析显示,BMI、超声心动图 PAP>35mmHg 和焦虑是与性别最密切相关的变量。

结论

在 SSc 患者中,男性倾向于与弥漫性疾病相关,而女性与钙沉积和自我报告的焦虑症状相关。两组患者的疾病相关残疾和 HRQoL 相似。

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