疲劳对系统性红斑狼疮患者健康相关生活质量和疾病认知的影响：一项单中心队列研究。
Impact of fatigue on health-related quality of life and illness perception in a monocentric cohort of patients with systemic lupus erythematosus.
机构信息
Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.
Department of Medical Biotechnologies, University of Siena, Siena, Italy.
出版信息
RMD Open. 2020 Feb;6(1). doi: 10.1136/rmdopen-2019-001133.
BACKGROUND
Fatigue is a very common and debilitating symptom in patients with systemic lupus erythematosus (SLE), even among those with a mild or inactive disease. The objective of this study is to define fatigue determinants and describe the impact of fatigue on health-related quality of life (HRQoL) and illness perception in a monocentric cohort of patients with SLE.
METHODS
This is a cross-sectional study. Adult patients with SLE were included. For each patient, demographics, medications, comorbidities, organ damage (Systemic Lupus International Collaborating Clinics Damage Index), active disease manifestations and Systemic Lupus Disease Activity Index scores were collected. It was evaluated if each patient met the definitions of remission and low disease activity. At enrolment, each patient completed the Short Form-36 (SF-36), Functional Assessment Chronic Illness Therapy-Fatigue (FACIT-F), Lupus Impact Tracker (LIT), Systemic Lupus Activity Questionnaire (SLAQ) and Brief Index of Lupus Damage (BILD). The FACIT-F questionnaire was also administered to a group of healthy controls.
RESULTS
223 patients were included (mean age 44.9±13.2 years, median disease duration 13 years). 18.2% had an active disease, 43.5% met the definition of remission on treatment, and 11.8% had a concomitant fibromyalgia. The median FACIT-F score of our cohort was significantly lower compared with that of healthy controls (40 vs 47; p<0.001). FACIT-F scores were irrespective of age, disease duration, disease activity and damage. FACIT-F score was significantly lower in patients with fibromyalgia (p<0.01). FACIT-F scores demonstrated a significant correlation with all other patient-reported outcomes: SF-36 (r=0.53-0.77), LIT (r=-0.78), SLAQ (r=-0.72) and BILD (r=-0.28).
CONCLUSIONS
Fatigue in patients with SLE has a strong negative impact on HRQoL and patient perception of the disease burden. Fatigue seems irrespective of disease activity but significantly influenced by the presence of fibromyalgia.
背景
疲劳是红斑狼疮患者（SLE）非常常见且使人虚弱的症状，即使在疾病轻度或不活跃的患者中也是如此。本研究的目的是确定疲劳的决定因素，并描述疲劳对 SLE 患者单中心队列的健康相关生活质量（HRQoL）和疾病认知的影响。
方法
这是一项横断面研究。纳入了成年 SLE 患者。对于每位患者，收集了人口统计学、药物、合并症、器官损害（系统性红斑狼疮国际合作临床损害指数）、活动疾病表现和系统性红斑狼疮疾病活动指数评分。评估每位患者是否符合缓解和低疾病活动的定义。入组时，每位患者完成了简短 36 项健康调查（SF-36）、慢性疾病治疗疲劳功能评估（FACIT-F）、狼疮影响跟踪器（LIT）、系统性红斑狼疮活动问卷（SLAQ）和狼疮损伤简短指数（BILD）。还向一组健康对照者发放了 FACIT-F 问卷。
结果
共纳入 223 例患者（平均年龄 44.9±13.2 岁，中位疾病病程 13 年）。18.2%的患者有活动期疾病，43.5%的患者经治疗达到缓解定义，11.8%的患者合并纤维肌痛。与健康对照组相比，我们队列的中位 FACIT-F 评分显著较低（40 对 47；p<0.001）。FACIT-F 评分与年龄、疾病病程、疾病活动度和损害无关。纤维肌痛患者的 FACIT-F 评分显著较低（p<0.01）。FACIT-F 评分与所有其他患者报告的结果显著相关：SF-36（r=0.53-0.77）、LIT（r=-0.78）、SLAQ（r=-0.72）和 BILD（r=-0.28）。
结论
SLE 患者的疲劳对 HRQoL 和患者对疾病负担的认知有强烈的负面影响。疲劳似乎与疾病活动无关，但显著受纤维肌痛的影响。
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