Broegelmann Research Laboratory, The Gade Institute, Laboratory Bldg,, Haukeland University Hospital, N-5021 Bergen, Norway.
Arthritis Res Ther. 2011;13(5):R167. doi: 10.1186/ar3487. Epub 2011 Oct 13.
Fatigue is prevalent in primary Sjögren's syndrome (pSS), and contributes to the considerably reduced health related quality of life in this disease. The symptom is included in proposed disease activity and outcome measures for pSS. Several studies indicate that there is an inflammatory component of fatigue in pSS and other chronic inflammatory rheumatic diseases. The purpose of this study was to investigate fatigue change in pSS in a longitudinal study, and explore whether any clinical or laboratory variables at baseline, including serum cytokines, were associated with a change in fatigue scores over time.
A clinical and laboratory investigation of 141 patients fulfilling the American-European consensus criteria of pSS was undertaken in the period May 2004 to April 2005. Median time since diagnosis was 5.5 years. Examinations included the fatigue questionnaires: fatigue severity scale (FSS), fatigue visual analogue scale (VAS), functional assessment of chronic illness therapy-fatigue (FACIT-F) and medical outcome study short form-36 (SF-36) vitality, which were repeated in a follow-up investigation in January and February 2010.
A total of 122 patients (87%) responded at both time-points. Thirty-five percent of patients experienced a clinically significant FSS increase. On the group level, fatigue measures did not change except that there was a slight deterioration in SF-36 vitality score. High serum anti-Sjögren's syndrome A antigen (anti-SSA) showed weak associations with high baseline fatigue, and patients with increasing fatigue had lower baseline unstimulated whole salivary volume. Weak associations between increasing fatigue and serum immunoglobulin G (IgG), and the pro-inflammatory cytokine interleukin-17 (IL-17), were observed. Baseline sicca symptoms correlated with higher fatigue both at baseline and with increasing fatigue over time. Linear regression analysis did not identify any predictive ability of clinical or laboratory measures on fatigue change over time.
Fatigue remained mainly unchanged over time. Using multivariate models did not reveal any clinical or laboratory predictors of fatigue change over time.
疲劳是原发性干燥综合征（pSS）的常见症状，会显著降低该病患者的健康相关生活质量。该症状已被纳入 pSS 的疾病活动度和预后评估指标中。多项研究表明，pSS 和其他慢性炎症性风湿病中存在与疲劳相关的炎症成分。本研究旨在通过纵向研究调查 pSS 患者的疲劳变化，并探讨基线时的任何临床或实验室变量（包括血清细胞因子）是否与随时间推移的疲劳评分变化相关。
2004 年 5 月至 2005 年 4 月期间，对符合美国-欧洲 pSS 共识标准的 141 例患者进行了临床和实验室检查。中位诊断后时间为 5.5 年。检查包括疲劳问卷：疲劳严重程度量表（FSS）、疲劳视觉模拟量表（VAS）、慢性病治疗疲劳功能评估（FACIT-F）和医学结局研究简表 36 项健康调查（SF-36）活力。这些问卷在 2010 年 1 月和 2 月的随访调查中重复进行。
共有 122 例患者（87%）在两次时间点均做出回应。35%的患者出现临床显著的 FSS 增加。在组水平上，除 SF-36 活力评分略有下降外，疲劳评估无变化。高血清抗干燥综合征 A 抗原（抗-SSA）与基线时高疲劳程度呈弱相关，且疲劳程度增加的患者基础唾液分泌量较低。随着疲劳程度的增加，血清免疫球蛋白 G（IgG）和促炎细胞因子白细胞介素-17（IL-17）与疲劳程度呈弱相关。基础干燥症状与基线时及随时间推移的疲劳程度增加均呈正相关。线性回归分析未发现任何临床或实验室指标对随时间推移的疲劳变化具有预测能力。
疲劳在较长时间内基本保持不变。使用多变量模型也未发现任何临床或实验室指标可预测随时间推移的疲劳变化。
