Novaes Gilberto Santos, Perez Mariana Ortega, Beraldo Maria Beatriz Bray, Pinto Camila Rodrigues Costa, Gianini Reinaldo José
Medical and Health Science Center of the Pontifícia Universidade Católica de São Paulo, Brasil.
Rev Bras Reumatol. 2011 Sep-Oct;51(5):451-5.
To investigate the correlation of fatigue with pain in rheumatoid arthritis patients and with disability in osteoarthritis patients.
Twenty patients with rheumatoid arthritis and 20 patients with osteoarthritis were evaluated. The degree of fatigue was evaluated with a visual analogue scale and the Multidimensional Assessment of Fatigue. Pain was evaluated with a visual analogue scale as well as Patient Global Assessment. For disability evaluation, the Health Assessment Questionnaire was performed. Age, gender, disease duration, education, income, antirheumatic drugs used and comorbidity were also obtained. Statistical analysis included Fisher exact, Shapiro-Wilk, Kruskal-Wallis and Spearman tests. The significance level was 0.05.
Fatigue was more significantly increased in patients with osteoarthritis than in patients with rheumatoid arthritis when evaluated with Multidimensional Assessment of Fatigue (P < 0.05). Pain was found to correlate with fatigue evaluated with visual analogue scale or Multidimensional Assessment of Fatigue in patients with rheumatoid arthritis (r = 0.46; P < 0.05). Health Assessment Questionnaire was associated with fatigue visual analogue scale in patients with osteoarthritis (r = 0.54; P < 0.05). Patient Global Assessment correlates with fatigue visual analogue scale (r = 0.44; P < 0.003). Patients were similar in both groups: all females, similar mean age, with long disease duration and low income.
Our results corroborate that fatigue in rheumatoid arthritis patients correlates with the degree of pain, while in osteoarthritis patients it is associated with disability. Therefore, we found that fatigue has different correlates in osteoarthritis and rheumatoid arthritis, and we suggest that disability, not pain, is a correlate of fatigue in osteoarthritis patients.
探讨类风湿关节炎患者疲劳与疼痛以及骨关节炎患者疲劳与残疾之间的相关性。
对20例类风湿关节炎患者和20例骨关节炎患者进行评估。采用视觉模拟评分法和疲劳多维评估法评估疲劳程度。采用视觉模拟评分法以及患者整体评估法评估疼痛。进行健康评估问卷以评估残疾情况。还获取了年龄、性别、病程、教育程度、收入、使用的抗风湿药物及合并症等信息。统计分析包括Fisher精确检验、Shapiro-Wilk检验、Kruskal-Wallis检验和Spearman检验。显著性水平为0.05。
采用疲劳多维评估法时，骨关节炎患者的疲劳程度比类风湿关节炎患者显著增加（P < 0.05）。在类风湿关节炎患者中，发现疼痛与采用视觉模拟评分法或疲劳多维评估法评估的疲劳相关（r = 0.46；P < 0.05）。在骨关节炎患者中，健康评估问卷与疲劳视觉模拟评分相关（r = 0.54；P < 0.05）。患者整体评估与疲劳视觉模拟评分相关（r = 0.44；P < 0.003）。两组患者情况相似：均为女性，平均年龄相近，病程长且收入低。
我们的结果证实，类风湿关节炎患者的疲劳与疼痛程度相关，而在骨关节炎患者中，疲劳与残疾相关。因此，我们发现疲劳在骨关节炎和类风湿关节炎中有不同的相关因素，并且我们认为，在骨关节炎患者中，残疾而非疼痛是疲劳的一个相关因素。
