Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital Hang Zhou Medical College, 108, Shan Tang Road, Hangzhou, 310016, Zhejiang Province, China.
Department of Pathology, Zhejiang Provincial People's Hospital, People's Hospital Hang Zhou Medical College, Zhejiang, China.
Health Qual Life Outcomes. 2019 Jul 25;17(1):130. doi: 10.1186/s12955-019-1200-3.
Fatigue is an important clinical finding in patients with chronic hepatitis virus infection. However, studies assessing fatigue in patients with chronic hepatitis B (CHB) are very limited. This study aimed to quantify the severity of fatigue in patients with CHB, to determine whether perceived fatigue reflects impairment of functional ability, and to explore potential causes.
A total of 133 patients with histologically proven CHB and 59 community controls were assessed using the fatigue impact scale (FIS).
The degree of fatigue was significantly higher in patients with CHB than in controls (mean (range) FIS 24.9 (0-91) vs. 15.7 (0-31), p < 0.001). Fatigue experienced by patients with CHB was similar to that in primary biliary cirrhosis (PBC) (n = 20) (FIS 22.2 vs. 20.9, p = 0.28). No association was found between FIS and biochemistry and histological parameters of liver disease severity. Significant associations were found between fatigue severity and cognitive impairment (r = 0.39, p < 0.001), daytime somnolence (r = 0.32, p < 0.001), scores of the Chronic Liver Disease Questionnaire (r = - 0.31, p < 0.001), and autonomic symptoms (r = 0.43, p < 0.001). The level of autonomic symptom was the only factor independently associated with the degree of fatigue.
Fatigue is a significant problem of functional ability impairment in CHB and similar in degree to that in PBC patients. Fatigue in patients with CHB appears to be unrelated to the severity of liver disease but is associated with significant autonomic symptoms.
疲劳是慢性乙型肝炎（CHB）患者的重要临床发现。然而，评估 CHB 患者疲劳的研究非常有限。本研究旨在量化 CHB 患者的疲劳严重程度，确定感知疲劳是否反映了功能能力的损害，并探讨潜在的原因。
对 133 例经组织学证实的 CHB 患者和 59 名社区对照者进行疲劳影响量表（FIS）评估。
CHB 患者的疲劳程度明显高于对照组（FIS 平均值（范围）分别为 24.9（0-91）和 15.7（0-31），p<0.001）。CHB 患者的疲劳程度与原发性胆汁性肝硬化（PBC）（n=20）相似（FIS 分别为 22.2 和 20.9，p=0.28）。FIS 与肝功能严重程度的生化和组织学参数无相关性。疲劳严重程度与认知障碍（r=0.39，p<0.001）、日间嗜睡（r=0.32，p<0.001）、慢性肝病问卷评分（r=-0.31，p<0.001）和自主神经症状（r=0.43，p<0.001）显著相关。自主神经症状水平是唯一与疲劳程度相关的独立因素。
疲劳是 CHB 患者功能能力受损的一个重要问题，其严重程度与 PBC 患者相似。CHB 患者的疲劳似乎与肝脏疾病的严重程度无关，但与明显的自主神经症状相关。
