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类风湿关节炎和系统性硬化症患者疲劳程度及疾病相关因素的比较

Comparison of Level of Fatigue and Disease Correlates in Patients With Rheumatoid Arthritis and Systemic Sclerosis.

作者信息

Gök Kevser, Erol Kemal, Cengiz Gizem, Özgöçmen Salih

机构信息

Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Medical Faculty of Erciyes University, Kayseri, Turkey.

Department of Rheumatology, Medical Park Gaziosmanpaşa Hospital, İstanbul, Turkey.

出版信息

Arch Rheumatol. 2018 Jan 15;33(3):316-321. doi: 10.5606/ArchRheumatol.2018.6670. eCollection 2018 Sep.

Abstract

OBJECTIVES

This study aims to compare the levels of fatigue in patients with rheumatoid arthritis (RA) and systemic sclerosis (SSc) and to assess the potential influence of fatigue on clinical variables.

PATIENTS AND METHODS

Age- and sex-matched adult patients with SSc (n=50; 6 males, 44 females; mean age 47.7 years; range 23 to 72 years) and RA (n=51; 6 males, 45 females; mean age 50.8 years; range 23 to 71 years) were consecutively recruited. Patients were examined and evaluated for disease specific and generic outcome measures including disease activity parameters, physical functions, psychological status, and health related quality of life measures. Level of fatigue was assessed by Fatigue Severity Scale and Multidimensional Assessment of Fatigue scale. These were interviewed by the same experienced physician who was blind to clinical data.

RESULTS

Patients had similar educational and smoking status, as well as functioning and health related quality of life. However, patients with RA declared higher levels on visual analog scale-pain (p=0.012) and higher body mass index than patients with SSc (p<0.0001) and lower distances in six-minute walking test (p=0.002). Levels of fatigue were quite similar between patients with RA and SSc. Levels of fatigue, measured by different scales, were significantly correlated with physical functions and health related quality of life measures and psychometric variables in both groups; however, the correlation coefficients were relatively higher in patients with RA.

CONCLUSION

Fatigue is a major problem in patients with RA and SSc. Our findings revealed that level of fatigue was quite similar between patients with RA and SSc and significantly correlated with physical functions and health related quality of life. Patients with RA and SSc should be carefully evaluated for fatigue by using valid scales and the impact of fatigue on clinical measures should not be overlooked.

摘要

目的

本研究旨在比较类风湿关节炎(RA)和系统性硬化症(SSc)患者的疲劳程度,并评估疲劳对临床变量的潜在影响。

患者与方法

连续招募年龄和性别匹配的成年SSc患者(n = 50;男性6例,女性44例;平均年龄47.7岁;范围23至72岁)和RA患者(n = 51;男性6例,女性45例;平均年龄50.8岁;范围23至71岁)。对患者进行检查并评估疾病特异性和通用结局指标,包括疾病活动参数、身体功能、心理状态以及健康相关生活质量指标。通过疲劳严重程度量表和疲劳多维评估量表评估疲劳程度。由同一位对临床数据不知情的经验丰富的医生进行访谈调查。

结果

患者在教育程度和吸烟状况以及功能和健康相关生活质量方面相似。然而,RA患者在视觉模拟评分法疼痛方面的评分更高(p = 0.012),且体重指数高于SSc患者(p < 0.0001),在六分钟步行试验中的距离更短(p = 0.002)。RA患者和SSc患者的疲劳程度相当相似。两组中,通过不同量表测量的疲劳程度与身体功能、健康相关生活质量指标以及心理测量变量均显著相关;然而,RA患者的相关系数相对较高。

结论

疲劳是RA和SSc患者的一个主要问题。我们的研究结果显示,RA患者和SSc患者的疲劳程度相当相似,且与身体功能和健康相关生活质量显著相关。应使用有效量表对RA和SSc患者的疲劳进行仔细评估,且不应忽视疲劳对临床指标的影响。

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