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中风后疲劳

Post-stroke fatigue.

作者信息

Vuletić Vladimira, Lezaić Zeljka, Morović Sandra

机构信息

University Department of Neurology, Dubrava University Hospital, Zagreb, Croatia.

出版信息

Acta Clin Croat. 2011 Sep;50(3):341-4.

Abstract

Post-stroke fatigue is still a relatively unexplored, often neglected condition. The fatigue often manifests as physical and mental lack of energy, and many patients mention fatigue as one of the most difficult sequels to which they have to adjust. Our aim was to assess the fatigue in 35 three-month post-stroke patients and its relation to personal and stroke-related factors, and to compare them with 35 age- and sex-matched healthy control subjects. The main outcome measures for the fatigue were Fatigue Severity Scale (FSS) and Multidimensional Fatigue Inventory (MFI-20). Barthel index was used for functional status assessment, while anxiety and depressive symptoms were evaluated using Hospital Anxiety and Depression Scale (HADS). Study results showed fatigue to be frequent (45%) and often severe. Post-stroke patients showed higher values of general fatigue dimensions, physical fatigue and reduced activity. The number of subjects reporting fatigue problems on the FSS and MFI-20 scales was significantly greater in the stroke group (16/35; 45%) than in the control group (4/35; 11%; chi2 = 12.5; P < 0.001). Considering associations between fatigue and Barthel index score, age, sex, HADS-A (anxiety) and HADS-D (depression) scores, statistically significant associations were recorded between fatigue and anxiety (P = 0.01) and depression symptoms (P = 0.02). Global fatigue showed positive correlation with Barthel index score too (P = 0.01). Multivariate analysis showed that anxiety and depression symptoms could predict post-stroke fatigue (adjusted R2 = 0.556; P < 0.05). Clinical trials and follow-up studies to find an effective treatment for patients with post-stroke fatigue are warranted.

摘要

中风后疲劳仍然是一种相对未被充分探索且常被忽视的状况。疲劳通常表现为身心能量不足,许多患者将疲劳视为他们必须适应的最困难的后遗症之一。我们的目的是评估35名中风后三个月患者的疲劳情况及其与个人和中风相关因素的关系,并将他们与35名年龄和性别匹配的健康对照者进行比较。疲劳的主要结局指标是疲劳严重程度量表(FSS)和多维疲劳量表(MFI-20)。巴氏指数用于评估功能状态,而焦虑和抑郁症状则使用医院焦虑抑郁量表(HADS)进行评估。研究结果显示疲劳很常见(45%)且往往很严重。中风后患者在总体疲劳维度、身体疲劳和活动减少方面得分更高。在FSS和MFI-20量表上报告有疲劳问题的受试者数量,中风组(16/35;45%)显著多于对照组(4/35;11%;卡方 = 12.5;P < 0.001)。考虑到疲劳与巴氏指数评分、年龄、性别、HADS-A(焦虑)和HADS-D(抑郁)评分之间的关联,疲劳与焦虑(P = 0.01)和抑郁症状(P = 0.02)之间存在统计学显著关联。总体疲劳与巴氏指数评分也呈正相关(P = 0.01)。多变量分析表明,焦虑和抑郁症状可预测中风后疲劳(调整后的R2 = 0.556;P < 0.05)。有必要开展临床试验和随访研究,以找到治疗中风后疲劳患者的有效方法。

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