Feldthusen Caroline, Grimby-Ekman Anna, Forsblad-d'Elia Helena, Jacobsson Lennart, Mannerkorpi Kaisa
Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, SE-405 30 Gothenburg, Sweden.
J Rehabil Med. 2016 Apr 28;48(5):469-76. doi: 10.2340/16501977-2090.
To investigate the impact of disease-related aspects on long-term variations in fatigue in persons with rheumatoid arthritis.
Observational longitudinal study.
Sixty-five persons with rheumatoid arthritis, age range 20-65 years, were invited to a clinical examination at 4 time-points during the 4 seasons. Outcome measures were: general fatigue rated on visual analogue scale (0-100) and aspects of fatigue assessed by the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire. Disease-related variables were: disease activity (erythrocyte sedimentation rate), pain threshold (pressure algometer), physical capacity (six-minute walk test), pain (visual analogue scale (0-100)), depressive mood (Hospital Anxiety and Depression scale, depression subscale), personal factors (age, sex, body mass index) and season. Multivariable regression analysis, linear mixed effects models were applied.
The strongest explanatory factors for all fatigue outcomes, when recorded at the same time-point as fatigue, were pain threshold and depressive mood. Self-reported pain was an explanatory factor for physical aspects of fatigue and body mass index contributed to explaining the consequences of fatigue on everyday living. For predicting later fatigue pain threshold and depressive mood were the strongest predictors.
Pain threshold and depressive mood were the most important factors for fatigue in persons with rheumatoid arthritis.
探讨疾病相关因素对类风湿关节炎患者疲劳长期变化的影响。
观察性纵向研究。
邀请65名年龄在20 - 65岁之间的类风湿关节炎患者在四季中的4个时间点进行临床检查。观察指标包括：用视觉模拟量表（0 - 100）评定的一般疲劳程度，以及通过布里斯托尔类风湿关节炎疲劳多维问卷评估的疲劳相关方面。疾病相关变量包括：疾病活动度（红细胞沉降率）、疼痛阈值（压力痛觉计）、身体能力（6分钟步行试验）、疼痛（视觉模拟量表（0 - 100））、抑郁情绪（医院焦虑抑郁量表，抑郁分量表）、个人因素（年龄、性别、体重指数）和季节。采用多变量回归分析、线性混合效应模型。
在与疲劳同时记录时，所有疲劳结果的最强解释因素是疼痛阈值和抑郁情绪。自我报告的疼痛是疲劳身体方面的一个解释因素，体重指数有助于解释疲劳对日常生活的影响。对于预测后期疲劳，疼痛阈值和抑郁情绪是最强的预测因素。
疼痛阈值和抑郁情绪是类风湿关节炎患者疲劳的最重要因素。
