Moon Su-Jin, Kang Kwi Young, Kwok Seung-Ki, Ju Ji Hyeon, Hong Yeon-Sik, Park Sung-Hwan, Jeon Chan Hong, Choi Sang Tae, Song Jung-Soo, Min Jun-Ki
Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Int J Rheum Dis. 2018 Jun;21(6):1173-1184. doi: 10.1111/1756-185X.13320.
The purpose of this study was to identify whether determinants of health-related quality of life (HRQoL) in middle-aged female patients with systemic lupus erythematosus (SLE) differed according to the presence or absence of fibromyalgia.
One hundred and fifty-two patients with SLE and 139 healthy controls (HCs) completed the Medical Outcomes Study 36-Item Short Form (SF-36) and EuroQol EQ-5D questionnaires about HRQoL. Disease activity and cumulative disease damage were assessed with standard indices. Sleep quality was assessed using the Korean version of the Pittsburgh Sleep Quality Index (K-PSQI).
The mean EQ-5D and physical and mental components of SF-36 were lower in SLE patients with fibromyalgia (n = 41) than in those without fibromyalgia (n = 111) and HCs. The scores in all eight domains of the SF-36 were lower in SLE patients with fibromyalgia than in patients without fibromyalgia and HCs. Poor sleep (defined as a K-PSQI > 5) was reported by 85% of SLE patients with fibromyalgia, by 51% of patients without fibromyalgia, and by 33% of HCs. Multivariate logistic regression analysis showed that lower educational level, cumulative organ damage severity and poor sleep quality were independent determinants of HRQoL in SLE patients with fibromyalgia, whereas disease activity, sleep quality and depressive mood were independent determinants of HRQoL in those without fibromyalgia.
Poor sleep quality is the common independent risk factor for poor HRQoL in both middle-aged SLE patients with fibromyalgia and without fibromyalgia. Sleep quality improvement may improve HRQoL in female SLE patients, even in those without fibromyalgia.
本研究旨在确定中年系统性红斑狼疮（SLE）女性患者中，与健康相关的生活质量（HRQoL）的决定因素是否因是否存在纤维肌痛而有所不同。
152例SLE患者和139名健康对照者（HCs）完成了关于HRQoL的医学结局研究简明健康调查36项量表（SF-36）和欧洲五维度健康量表（EQ-5D）问卷。使用标准指标评估疾病活动度和累积疾病损伤。采用匹兹堡睡眠质量指数韩语版（K-PSQI）评估睡眠质量。
伴有纤维肌痛的SLE患者（n = 41）的平均EQ-5D以及SF-36的生理和心理分量表得分低于不伴有纤维肌痛的SLE患者（n = 111）和HCs。伴有纤维肌痛的SLE患者SF-36所有八个领域的得分均低于不伴有纤维肌痛的患者和HCs。85%伴有纤维肌痛的SLE患者、51%不伴有纤维肌痛的患者以及33%的HCs报告睡眠质量差（定义为K-PSQI>5）。多因素逻辑回归分析显示，教育水平较低、累积器官损伤严重程度和睡眠质量差是伴有纤维肌痛的SLE患者HRQoL的独立决定因素，而疾病活动度、睡眠质量和抑郁情绪是不伴有纤维肌痛的SLE患者HRQoL的独立决定因素。
睡眠质量差是中年伴有和不伴有纤维肌痛的SLE患者HRQoL差的共同独立危险因素。改善睡眠质量可能会改善女性SLE患者的HRQoL，即使是那些不伴有纤维肌痛的患者。
