Chen Yang Kun, Qu Jian-Feng, Xiao Wei Min, Li Wan Yi, Weng Han Yu, Li Wei, Liu Yong Lin, Luo Gen Pei, Fang Xue Wen, Ungvari Gabor S, Xiang Yu Tao
Department of Neurology, Dongguan People's Hospital, Dongguan, Guangdong Province, China.
Department of Radiology, Dongguan People's Hospital, Dongguan, Guangdong Province, China.
Int J Stroke. 2015 Jun;10(4):506-12. doi: 10.1111/ijs.12409. Epub 2014 Dec 3.
Fatigue is a common problem in ischemic stroke survivors. The mechanisms of poststroke fatigue are uncertain yet. The effects of it on functional status have rarely been studied.
The aim of this study was to investigate the risk factors of poststroke fatigue and its effect on activities of daily living and health-related quality of life in Chinese patients with ischemic stroke.
Two hundred and eighteen patients with ischemic stroke formed the study sample. A comprehensive assessment, including the Fatigue Severity Scale, Hamilton Depression Rating Scale, Lawton activities of daily living scale, and the stroke-specific quality of life scale, was conducted three-months after stroke. Magnetic resonance imaging scans focused on the evaluation of infarctions, white matter lesions, and brain atrophy.
In the whole sample, with Fatigue Severity Scale as the dependent variable in a linear regression model, Hamilton Depression Rating Scale, prestroke fatigue, and the National Institutes of Health Stroke Scale score at admission were significant correlates of Fatigue Severity Scale, accounting for 36% of the variance of it. When subjects with depression (Hamilton Depression Rating Scale ≥ 20 or current usage of antidepressants) were excluded, only Hamilton Depression Rating Scale and prestroke fatigue remained significant correlates of Fatigue Severity Scale, accounting for 33% of the variance of Fatigue Severity Scale. No magnetic resonance imaging variables correlated with Fatigue Severity Scale. In bivariate correlation analyses, Fatigue Severity Scale was significantly correlated with both activities of daily living and stroke-specific quality of life. In linear regression models, Fatigue Severity Scale independently contributed to activities of daily living accounting for 27% of the variance. Fatigue Severity Scale was also a significant contributor to stroke-specific quality of life accounting for 39% of the variance.
Depressive symptoms and prestroke fatigue are major correlates of poststroke fatigue while more severe poststroke fatigue is associated with poorer activities of daily living and health-related quality of life.
疲劳是缺血性脑卒中幸存者的常见问题。然而，卒中后疲劳的机制尚不确定。其对功能状态的影响鲜有研究。
本研究旨在探讨中国缺血性脑卒中患者卒中后疲劳的危险因素及其对日常生活活动和健康相关生活质量的影响。
218例缺血性脑卒中患者构成研究样本。卒中后3个月进行全面评估，包括疲劳严重程度量表、汉密尔顿抑郁量表、Lawton日常生活活动量表和卒中特异性生活质量量表。磁共振成像扫描着重评估梗死灶、白质病变和脑萎缩情况。
在整个样本中，以疲劳严重程度量表作为线性回归模型中的因变量，汉密尔顿抑郁量表、卒中前疲劳以及入院时的美国国立卫生研究院卒中量表评分是疲劳严重程度量表的显著相关因素，解释了其36%的变异。排除抑郁患者（汉密尔顿抑郁量表评分≥20或当前正在使用抗抑郁药）后，仅汉密尔顿抑郁量表和卒中前疲劳仍是疲劳严重程度量表的显著相关因素，解释了疲劳严重程度量表33%的变异。没有磁共振成像变量与疲劳严重程度量表相关。在双变量相关性分析中，疲劳严重程度量表与日常生活活动和卒中特异性生活质量均显著相关。在线性回归模型中，疲劳严重程度量表独立影响日常生活活动，解释了27%的变异。疲劳严重程度量表也是卒中特异性生活质量的重要影响因素，解释了39%的变异。
抑郁症状和卒中前疲劳是卒中后疲劳的主要相关因素，而更严重的卒中后疲劳与较差的日常生活活动和健康相关生活质量相关。
