红斑狼疮性系统性疾病对女性性功能的影响：一项横断面研究。

Impaired sexual function in women with systemic lupus erythematosus: a cross-sectional study.

机构信息

Systemic Autoimmune Diseases Unit, San Cecilio Hospital, Granada, Spain.

出版信息

Lupus. 2013 Sep;22(10):987-95. doi: 10.1177/0961203313500370.

DOI:10.1177/0961203313500370

PMID:23963430

Abstract

OBJECTIVE

The objectives of this paper are to compare sexual function and distress in women with systemic lupus erythematosus (SLE) and in healthy controls; to determine the association between disease characteristics, quality of life, psychopathology and sexual function; and to compare sexual function and distress of women according to age (reproductive and nonreproductive-age women).

METHODS

We conducted a cross-sectional study of 120 participants; 65 women had SLE (aged 18-65), and 55 were healthy, age-matched controls. The assessment included the Female Sexual Function Index (FSFI), Symptom Checklist-90-Revised (SCL-90-R), Short Form 36 health survey (SF-36), socio-demographic characteristics and the Systemic Lupus International Collaborating Clinics (SLICC) and SLE Disease Activity Index (SLEDAI) in SLE patients only.

RESULTS

Of 65 eligible patients with SLE, 61 (94%) responded; of 55 control subjects, 53 (96%) responded. The FSFI total score and subscale scores for desire, arousal, lubrication, orgasm and pain were significantly lower in patients with SLE. More somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid ideation, psychoticism, the Positive Symptom Total (PST), Positive Score Discomfort Index (PSDI), the use of psychotropic drugs, general health, vitality, social function, emotional role and mental health were significantly associated with changes in the patient group's sexuality. Multivariate analysis indicated that depression, PSDI and vitality were the variables significantly associated with low sexual function in patients with SLE.

CONCLUSIONS

Women with SLE reported significantly impaired sexual function compared with healthy controls. Impaired sexual function was associated with somatization, obsessive-compulsive behavior, interpersonal sensitivity, depression, hostility, paranoid ideation, psychoticism, PST, higher scores in the PSDI subscale, vitality, social functioning and mental health. These results indicate that, in daily practice, inquiring about sexuality and quality of life and screening for psychopathology are important for every patient with SLE, irrespective of their clinical characteristics.

摘要

目的

本文旨在比较系统性红斑狼疮（SLE）女性患者与健康对照者的性功能和困扰程度；确定疾病特征、生活质量、精神病理学与性功能之间的关系；并比较不同年龄段（生育期和非生育期）女性的性功能和困扰程度。

方法

我们进行了一项横断面研究，共纳入 120 名参与者；其中 65 名女性患有 SLE（年龄 18-65 岁），55 名女性为年龄匹配的健康对照者。评估内容包括女性性功能指数（FSFI）、症状清单 90 修订版（SCL-90-R）、健康调查简表 36（SF-36）、社会人口学特征以及仅在 SLE 患者中评估系统性红斑狼疮国际合作临床中心（SLICC）和 SLE 疾病活动指数（SLEDAI）。

结果

在符合条件的 65 例 SLE 患者中，有 61 例（94%）做出回应；在 55 例健康对照者中，有 53 例（96%）做出回应。SLE 患者的 FSFI 总分和欲望、唤起、润滑、性高潮和疼痛等各分项评分显著较低。躯体化、强迫症状、人际敏感、抑郁、焦虑、敌对、恐怖、偏执观念、精神病性、阳性症状总分（PST）、阳性症状痛苦指数（PSDI）、精神药物使用、一般健康、活力、社会功能、情感角色和心理健康等方面得分较高与患者组的性行为变化显著相关。多变量分析表明，抑郁、PSDI 和活力是与 SLE 患者性功能降低显著相关的变量。

结论

与健康对照者相比，SLE 女性报告的性功能显著受损。性功能受损与躯体化、强迫行为、人际敏感、抑郁、敌对、偏执观念、精神病性、PST、PSDI 分项评分较高、活力、社会功能和心理健康有关。这些结果表明，在日常临床实践中，询问患者的性生活和生活质量，并对精神病理学进行筛查，对于每一位 SLE 患者都非常重要，无论其临床特征如何。