Ilhan Birkan, Can Meryem, Alibaz-Oner Fatma, Yilmaz-Oner Sibel, Polat-Korkmaz Ozge, Ozen Gulsen, Mumcu Gonca, Maradit Kremers Hilal, Direskeneli Haner
Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey.
Department of Rheumatology, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey.
Int J Rheum Dis. 2018 Dec;21(12):2139-2145. doi: 10.1111/1756-185X.12839. Epub 2016 Feb 23.
Fatigue is a common symptom of chronic inflammatory diseases. The objective of this study was to investigate fatigue in patients with Behçet's syndrome (BS) and to examine the relationship between fatigue and disease activity, quality of life, anxiety and depression.
This is a cross-sectional study of 123 BS patients and 71 healthy controls in Turkey. All subjects completed the Multidimensional Assessment of Fatigue (MAF) questionnaire, Short form-36 (SF-36), Hospital Anxiety and Depression (HADS) scale and Health Assessment Questionnaire (HAQ). Disease activity among BS patients was assessed using the Behçet Syndrome Activity Scale (BSAS) and the physician's global assessment (PGA).
BS patients had significantly higher MAF, HADS-depression (HADS-D) and HADS-anxiety (HADS-A) scores than the healthy controls (P < 0.001). Both the physical and mental components of the SF-36 scale were impaired in BS patients (P = 0.0001). BS patients with active disease, depression and anxiety had significantly higher MAF scores compared to BS patients without active disease, depression and anxiety (P = 0.0001). MAF scores showed positive correlations with HADS-A, HADS-D, HAQ scores and negative correlations with SF-36 mental and physical components. In regression analyses, depression, anxiety and physical dysfunction were significantly associated with fatigue, after adjusting for age, sex, SF-36 physical and mental scores, HAQ, HADS-A, HADS-D and BSAS scores (P < 0.05). Decreases in SF-36 physical and mental scores were significant predictive factors for high MAF score in healthy controls (P < 0.05).
Fatigue is common in clinically active BS patients compared with healthy controls and inactive BS patients. Depression, anxiety and physical dysfunction were significantly associated with fatigue.
疲劳是慢性炎症性疾病的常见症状。本研究的目的是调查白塞病（BS）患者的疲劳情况，并探讨疲劳与疾病活动度、生活质量、焦虑和抑郁之间的关系。
这是一项对土耳其123例BS患者和71例健康对照者的横断面研究。所有受试者均完成了疲劳多维评估（MAF）问卷、简明健康状况调查量表（SF-36）、医院焦虑抑郁量表（HADS）和健康评估问卷（HAQ）。采用白塞病活动量表（BSAS）和医生整体评估（PGA）评估BS患者的疾病活动度。
BS患者的MAF、HADS抑郁（HADS-D）和HADS焦虑（HADS-A）得分显著高于健康对照者（P<0.001）。BS患者SF-36量表的生理和心理成分均受损（P=0.0001）。与无活动性疾病、抑郁和焦虑的BS患者相比，有活动性疾病、抑郁和焦虑的BS患者MAF得分显著更高（P=0.0001）。MAF得分与HADS-A、HADS-D、HAQ得分呈正相关，与SF-36心理和生理成分呈负相关。在回归分析中，调整年龄、性别、SF-36生理和心理得分、HAQ、HADS-A、HADS-D和BSAS得分后，抑郁、焦虑和身体功能障碍与疲劳显著相关（P<0.05）。SF-36生理和心理得分的降低是健康对照者MAF得分高的显著预测因素（P<0.05）。
与健康对照者和非活动性BS患者相比，临床上活动性BS患者中疲劳很常见。抑郁、焦虑和身体功能障碍与疲劳显著相关。
