Garip Yesim, Eser Filiz, Aktekin Lale Akbulut, Bodur Hatice
Numune Training and Research Hospital, Physical Medicine and Rehabilitation Department, Samanpazari, Ankara, Turkey.
Acta Reumatol Port. 2011 Oct-Dec;36(4):364-9.
Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic symmetric polyarthritis causing progressive joint destruction and disability. Major patient complaints are pain, disability and fatigue. The aim of this study is to assess fatigue and its association with disease-specific variables (severity of pain, disease activity, and functional status) in patients with RA.
A total of 160 RA patients were included in the study. Fatigue was measured by using Fatigue Symptom Inventory (FSI). The quadrivariate Disease Activity Score-28 (DAS28) was used for evaluating disease activity and Health Assessment Questionnaire (HAQ) for determining functional status. Severity of pain was measured by using 10 cm Visual Analog Scale-Pain (VAS-pain).
Intensity items of FSI (most fatigue, least fatigue, average fatigue, current fatigue) were strongly correlated with DAS28, HAQ, and VAS pain (p=0.000). When the correlation coefficients were analyzed, current fatigue showed the highest correlation with VAS-pain (r: 0.96). This was followed by DAS28 and HAQ, respectively (r: 0.77 and 0.70) (p=0.000). Duration items of FSI (number of days fatigued, amount of time fatigued) were significantly correlated with DAS28, HAQ, and VAS pain (p=0.000). Also there were significant positive correlations between interference scale of FSI and DAS28, HAQ, and VAS-pain (r: 0.68, 0.61 and 0.67, respectively) (p=0.000). None of FSI subgroups showed statistically significant correlation with disease duration.
Fatigue is strongly associated with severity of pain, disease activity and functional status. Fatigue should be included in clinical practice and clinical trials as a RA outcome measure.
类风湿关节炎（RA）是一种自身免疫性疾病，其特征为慢性对称性多关节炎，可导致进行性关节破坏和残疾。患者的主要主诉是疼痛、残疾和疲劳。本研究的目的是评估RA患者的疲劳及其与疾病特异性变量（疼痛严重程度、疾病活动度和功能状态）之间的关联。
本研究共纳入160例RA患者。使用疲劳症状量表（FSI）测量疲劳程度。采用四变量28关节疾病活动评分（DAS28）评估疾病活动度，使用健康评估问卷（HAQ）确定功能状态。使用10厘米视觉模拟疼痛量表（VAS-疼痛）测量疼痛严重程度。
FSI的强度项目（最疲劳、最不疲劳、平均疲劳、当前疲劳）与DAS28、HAQ和VAS疼痛评分密切相关（p=0.000）。分析相关系数时，当前疲劳与VAS疼痛的相关性最高（r：0.96）。其次分别是DAS28和HAQ（r：0.77和0.70）（p=0.000）。FSI的持续时间项目（疲劳天数、疲劳时间）与DAS28、HAQ和VAS疼痛评分显著相关（p=0.000）。此外，FSI的干扰量表与DAS28、HAQ和VAS疼痛评分之间也存在显著正相关（r分别为0.68、0.61和0.67）（p=0.000）。FSI的任何亚组与疾病持续时间均无统计学显著相关性。
疲劳与疼痛严重程度、疾病活动度和功能状态密切相关。疲劳应作为RA的一项结局指标纳入临床实践和临床试验中。
