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多发性硬化症中男性与女性的身体、心理和社会功能差异:一项在中国开展的多中心横断面研究

Differences in physical, mental, and social functions between males and females in multiple sclerosis: A multicenter cross-sectional study in China.

作者信息

Zhao Zhengyang, Zhang Ying, Du Qin, Chen Hongxi, Shi Ziyan, Wang Jiancheng, Qiu Yuhan, Yan Chao, Zhou Hongyu

机构信息

Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan Province, China 610041.

Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan Province, China 610041.

出版信息

Mult Scler Relat Disord. 2021 Feb;48:102693. doi: 10.1016/j.msard.2020.102693. Epub 2020 Dec 19.

Abstract

Background Sex-specific differences in multiple sclerosis (MS) have been recognized, but few were known about how sex influences the characteristics of MS in Asian and the social burden of MS. This study aimed to investigate the symptoms, mental health, and social functions of Chinese MS patients and find differences between sexes. Methods MS patients were enrolled from January 2004 to September 2018. A questionnaire was distributed by 47 medical centers. Patients' physical symptoms, negative emotions, interpersonal communication, social intercourse, employment condition, and suicidal thoughts and behavior were collected. Patients were asked to fill in the questionnaire independently and undergo Expanded Disability Status Scale (EDSS) measurement. Unpaired t-tests between sexes were conducted for normally distributed continuous variables. Mann-Whitney u-tests were conducted for non-normally distributed data. Chi-square tests, Fisher exact tests and rank sum tests were performed for categorical variables. Results 931 patients were enrolled and 631 were female. Frequency of fatigue and pain were higher in female MS patients (P<0.05), while male patients complained more weakness, diplopia, sexual dysfunction, and micturition and defecation dysfunction (P<0.05). Females were more likely to experience sadness and helplessness than males (P<0.05) while males were more likely to experience nonacceptance than females (P<0.05). MS had a worse influence on male patients in relationships with family and friends (P<0.05). The employment rate of MS patients was 39.31%. The frequency of suicidal attempt was 2.36%, which was higher than general population. Conclusions The study provided evidence that characteristics of MS were different between males and females, and influence in mental and social function was a common problem among MS patients. More attention should be paid to the mental health and social function of MS patients.

摘要

背景

多发性硬化症(MS)存在性别差异已得到公认,但关于性别如何影响亚洲MS的特征以及MS的社会负担却知之甚少。本研究旨在调查中国MS患者的症状、心理健康和社会功能,并找出性别差异。方法:2004年1月至2018年9月招募MS患者。由47个医疗中心发放问卷。收集患者的身体症状、负面情绪、人际沟通、社交、就业状况以及自杀想法和行为。要求患者独立填写问卷并进行扩展残疾状态量表(EDSS)测量。对正态分布的连续变量进行性别间的独立样本t检验。对非正态分布数据进行曼-惠特尼U检验。对分类变量进行卡方检验、费舍尔精确检验和秩和检验。结果:共纳入931例患者,其中女性631例。女性MS患者疲劳和疼痛的发生率更高(P<0.05),而男性患者抱怨更多的是虚弱、复视、性功能障碍以及排尿和排便功能障碍(P<0.05)。女性比男性更容易感到悲伤和无助(P<0.05),而男性比女性更容易感到不被接受(P<0.05)。MS对男性患者在与家人和朋友的关系方面影响更严重(P<0.05)。MS患者的就业率为39.31%。自杀未遂的发生率为2.36%,高于一般人群。结论:该研究提供了证据表明MS在男性和女性之间存在特征差异,并且对心理和社会功能的影响是MS患者中的常见问题。应更加关注MS患者的心理健康和社会功能。

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