Maddali-Bongi S, Del Rosso A, Mikhaylova S, Francini B, Branchi A, Baccini M, Matucci-Cerinic M
Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
Clin Exp Rheumatol. 2014 Nov-Dec;32(6 Suppl 86):S-15-20. Epub 2014 May 21.
In systemic sclerosis (SSc), the frequent involvement of hand and face leads to their disability. We aimed to assess influence of hand and face disability on global disability and Health related Quality of life (HRQoL).
119 SSc patients were assessed for global disability by HAQ, HRQoL, by SF36; hand disability by HAMIS, CHFDS, fist closure and hand opening measures; face disability by MHISS and mouth opening measure.
Diffuse SSc (dSSc) patients present higher HAQ, lower Summary Physical Index (SPI) of SF36, major hand disability at hand (higher HAMIS, CHFDS, fist closure, lower hand opening) and face (lower mouth opening, higher MHISS) than lSSc patients (p<0.05). SPI of SF36 is negatively correlated with MHISS, CHFDS, HAMIS and positively correlated to mouth and hand opening (p<0.05). Summary Mental Index (SMI) of SF36 is negatively correlated with MHISS (p<0.05). HAQ is negatively correlated with mouth opening and positively correlated to MHISS, HAMIS, CHFDS (p<0.05). By hierarchical multiple linear regression, SPI of SF36 is significantly associated with total MHISS (B=-0.34; t=-3.78; p<0.001) and CHFDS (B=-0.27; t=-3.01; p=0.003), together, explaining 22% of SPI variance. SMI of SF36 is significantly associated only with MHISS total score (B=-0.22; t=-2.41; p=0.017), explaining 4% of its variance. HAQ is significantly associated with CHFDS score (B=0.61; t=7.90; p<0.001), explaining 36% of HAQ variance.
dSSc patients present higher global and local disability, and lower HRQoL in SPI than lSSc patients. Local disabilities, assessed by CHDFS and MHISS, are independently related to global disability and HRQoL.
在系统性硬化症（SSc）中，手部和面部频繁受累会导致功能障碍。我们旨在评估手部和面部功能障碍对整体功能障碍及健康相关生活质量（HRQoL）的影响。
通过健康评估问卷（HAQ）评估119例SSc患者的整体功能障碍，通过SF-36评估其HRQoL；通过手部功能障碍评分系统（HAMIS）、加拿大手部功能障碍评分（CHFDS）、握拳和伸掌测量评估手部功能障碍；通过面部功能障碍严重程度量表（MHISS）和张口测量评估面部功能障碍。
与局限性系统性硬化症（lSSc）患者相比，弥漫性系统性硬化症（dSSc）患者的HAQ更高，SF-36的躯体健康总评分（SPI）更低，手部功能障碍更严重（HAMIS、CHFDS更高，握拳更差，伸掌更差），面部功能障碍也更严重（张口更小，MHISS更高）（p<0.05）。SF-36的SPI与MHISS、CHFDS、HAMIS呈负相关，与张口和伸掌呈正相关（p<0.05）。SF-36的心理健康总评分（SMI）与MHISS呈负相关（p<0.05）。HAQ与张口呈负相关，与MHISS、HAMIS、CHFDS呈正相关（p<0.05）。通过分层多元线性回归分析，SF-36的SPI与MHISS总分（B=-0.34；t=-3.78；p<0.001）和CHFDS（B=-0.27；t=-3.01；p=0.003）显著相关，二者共同解释了SPI变异的22%。SF-36的SMI仅与MHISS总分显著相关（B=-0.22；t=-2.41；p=0.017），解释了其变异的4%。HAQ与CHFDS评分显著相关（B=0.61；t=7.90；p<0.001），解释了HAQ变异的36%。
与lSSc患者相比，dSSc患者的整体和局部功能障碍更严重，SPI中的HRQoL更低。通过CHDFS和MHISS评估的局部功能障碍与整体功能障碍和HRQoL独立相关。
