Krupp L B, LaRocca N G, Muir-Nash J, Steinberg A D
Department of Neurology, State University of New York, Stony Brook 11794-8121.
Arch Neurol. 1989 Oct;46(10):1121-3. doi: 10.1001/archneur.1989.00520460115022.
Fatigue is a prominent disabling symptom in a variety of medical and neurologic disorders. To facilitate research in this area, we developed a fatigue severity scale, subjected it to tests of internal consistency and validity, and used it to compare fatigue in two chronic conditions: systemic lupus erythematosus and multiple sclerosis. Administration of the fatigue severity scale to 25 patients with multiple sclerosis, 29 patients with systemic lupus erythematosus, and 20 healthy adults revealed that the fatigue severity scale was internally consistent, correlated well with visual analogue measures, clearly differentiated controls from patients, and could detect clinically predicted changes in fatigue over time. Fatigue had a greater deleterious impact on daily living in patients with multiple sclerosis and systemic lupus erythematosus compared with controls. The results further showed that fatigue was largely independent of self-reported depressive symptoms and that several characteristics could differentiate fatigue that accompanies multiple sclerosis from fatigue that accompanies systemic lupus erythematosus. This study demonstrates (1) the clinical and research applications of a scale that measures fatigue severity and (2) helps to identify features that distinguish fatigue between two chronic medical disorders.
疲劳是多种医学和神经疾病中一种突出的致残症状。为推动该领域的研究，我们制定了疲劳严重程度量表，对其进行了内部一致性和效度测试，并使用该量表比较了两种慢性病——系统性红斑狼疮和多发性硬化症——中的疲劳情况。对25例多发性硬化症患者、29例系统性红斑狼疮患者和20名健康成年人进行疲劳严重程度量表测试后发现，该量表具有内部一致性，与视觉模拟测量法相关性良好，能清晰区分对照组和患者，且能检测出临床上预测的疲劳随时间的变化。与对照组相比，疲劳对多发性硬化症和系统性红斑狼疮患者的日常生活产生了更大的有害影响。结果还表明，疲劳在很大程度上独立于自我报告的抑郁症状，并且有几个特征可以区分多发性硬化症伴发的疲劳和系统性红斑狼疮伴发的疲劳。本研究证明了（1）一种测量疲劳严重程度的量表的临床和研究应用，以及（2）有助于识别区分两种慢性疾病中疲劳的特征。
