Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Col. Sección XVI, Tlalpan, Mexico City, CP 14000, Mexico.
Rheumatol Int. 2018 Apr;38(4):631-640. doi: 10.1007/s00296-017-3904-1. Epub 2017 Dec 15.
The objective of this study is to describe aspects of health-related quality of life (HRQOL) in Mexican patients with antineutrophil cytoplasmic-associated vasculitis (AAV). Cross-sectional comparison study includes patients with established AAV and a comparison group with rheumatoid arthritis (RA), chronic kidney disease (CKD), and healthy subjects. Variables considered were: socio-demographic data, comorbidities, laboratory, disease activity, damage, and Physician's and Patient's Global Assessment (PhGA and PtGA). The following measurements were done: Pittsburg sleep quality index, Multidimesional Fatigue Inventory (MFI-20), Hospital Anxiety and Depression Scale, Short Form 36 questionnaire (SF-36), and Health Assessment Questionnaire. 60 patients with AAV were included, median age 54 years, and 60% female. Significant differences were found only in the bodily pain domain of the SF-36 (p = 0.01). Aspects of disease relevant for AAV patients were: fatigue and lack of energy; visual abnormalities; neuropathy; renal impairment; arthritis, and sinusitis. Greater total score on MFI-20 (p < 0.001) and worse PtGA (p = 0.01) were associated with worse physical health. Higher PhGA values were associated with worse physical quality of life (p = 0.01). Greater fatigue score (p = 0.002), greater anxiety-depression score (p = 0.005), and worse PtGA (p = 0.01) were associated with worse mental health quality of life. No differences were found in prevalence of sleep impairment, anxiety, depression, or disability between groups. AAV patients experienced more general and physical fatigue (p < 0.0001), and reduced activity (p = 0.01) than healthy subjects, but similar to RA and CKD patients. Vasculitis has negative effects on patients' physical and mental HRQOL.
本研究旨在描述墨西哥抗中性粒细胞胞浆抗体相关性血管炎（AAV）患者的健康相关生活质量（HRQOL）方面。这是一项横断面比较研究，纳入了确诊的 AAV 患者以及类风湿关节炎（RA）、慢性肾脏病（CKD）和健康对照组患者。所考虑的变量包括：社会人口统计学数据、合并症、实验室、疾病活动度、损伤以及医生和患者整体评估（PhGA 和 PtGA）。进行了以下测量：匹兹堡睡眠质量指数、多维疲劳量表（MFI-20）、医院焦虑和抑郁量表、健康调查简表 36 项（SF-36）和健康评估问卷。共纳入 60 例 AAV 患者，中位年龄 54 岁，女性占 60%。仅在 SF-36 的身体疼痛领域发现有显著差异（p=0.01）。与 AAV 患者相关的疾病方面包括：疲劳和乏力；视力异常；神经病；肾功能不全；关节炎和鼻窦炎。MFI-20 的总分更高（p<0.001）和 PtGA 更差（p=0.01）与更差的身体健康相关。更高的 PhGA 值与更差的身体生活质量相关（p=0.01）。更高的疲劳评分（p=0.002）、更高的焦虑抑郁评分（p=0.005）和更差的 PtGA（p=0.01）与更差的心理健康质量相关。各组之间在睡眠障碍、焦虑、抑郁或残疾的患病率方面没有差异。与健康对照组相比，AAV 患者经历了更多的一般和身体疲劳（p<0.0001）以及活动受限（p=0.01），但与 RA 和 CKD 患者相似。血管炎对患者的身体和心理健康 HRQOL 有负面影响。
