结节病疲劳的预测因素：运动试验的价值。

Predictors of fatigue in sarcoidosis: The value of exercise testing.

作者信息

Strookappe Bert, De Vries Jolanda, Elfferich Marjon, Kuijpers Petra, Knevel Ton, Drent Marjolein

机构信息

Dept. of Physical Therapy Hospital Gelderse Vallei (ZGV), Ede, Netherlands; ild Care Foundation Research Team, Ede, Netherlands; ILD Center of Excellence, St. Antonius Hospital Nieuwegein, Nieuwegein, Netherlands.

ild Care Foundation Research Team, Ede, Netherlands; Dept. of Medical Psychology, St. Elisabeth Hospital Tilburg, CoRPS, Tilburg University, Netherlands; Dept. of Medical and Clinical Psychology, CoRPS, Tilburg University, Netherlands.

出版信息

Respir Med. 2016 Jul;116:49-54. doi: 10.1016/j.rmed.2016.05.010. Epub 2016 May 12.

DOI:10.1016/j.rmed.2016.05.010

PMID:27296820

Abstract

BACKGROUND

Sarcoidosis patients often are troubled by dyspnea, exercise limitation, and fatigue. Many patients (up to 50-81%) suffer from sarcoidosis-associated fatigue. The etiology of fatigue in sarcoidosis is still unclear.

OBJECTIVE

The aim of this study was to assess the relationship between fatigue and both exercise capacity and clinical characteristics in sarcoidosis patients. Additionally, we studied the predictive value of exercise test results and other relevant clinical characteristics for the independent variable of fatigue.

METHODS

From November 2012 to September 2014, 201 sarcoidosis outpatients were referred to the Dutch ILD care foundation expertise team, 146 of whom were included in this retrospective cohort study. All patients completed the Fatigue Assessment Scale (FAS). Exercise capacity was assessed by the 6-min walking distance (6MWD) and steep ramp test (SRT) result. Clinical data were gathered from the medical records.

RESULTS

Exercise capacity only showed a weak correlation with fatigue (r = 0.25, p = 0.002 for 6MWD % of predicted; r = 0.24, p = 0.003 for SRT). Fatigue was not correlated with the demographic variables of age, body mass index, or time since diagnosis. Inflammatory markers, lung function tests, and hand grip strength showed no significant correlations with fatigue. Backward multiple regression analysis showed that only female sex (t = -2,614, p = 0.01) and 6MWD % of predicted (t = -2.773, p = 0.006) were independent predictors of fatigue. However, the r(2) indicated that these two variables together explained only 11% of the FAS score.

CONCLUSIONS

These results show that exercise capacity partly predicts patients' fatigue scores. Fatigue was not explained by lung function test results, inflammatory markers, or other clinical parameters.

摘要

背景

结节病患者常受呼吸困难、运动受限和疲劳困扰。许多患者（高达50%-81%）患有结节病相关疲劳。结节病疲劳的病因仍不清楚。

目的

本研究旨在评估结节病患者疲劳与运动能力及临床特征之间的关系。此外，我们研究了运动测试结果和其他相关临床特征对疲劳这一自变量的预测价值。

方法

2012年11月至2014年9月，201名结节病门诊患者被转诊至荷兰间质性肺病护理基金会专家团队，其中146名被纳入这项回顾性队列研究。所有患者均完成疲劳评估量表（FAS）。通过6分钟步行距离（6MWD）和陡坡试验（SRT）结果评估运动能力。从病历中收集临床数据。

结果

运动能力与疲劳仅呈弱相关（6MWD预测值百分比：r = 0.25，p = 0.002；SRT：r = 0.24，p = 0.003）。疲劳与年龄、体重指数或诊断后的时间等人口统计学变量无关。炎症标志物、肺功能测试和握力与疲劳无显著相关性。向后多元回归分析显示，仅女性（t = -2.614，p = 0.01）和6MWD预测值百分比（t = -2.773，p = 0.006）是疲劳的独立预测因素。然而，r²表明这两个变量共同仅解释了FAS评分的11%。