Kroenke K, Wood D R, Mangelsdorff A D, Meier N J, Powell J B
Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Tex. 78234-6200.
JAMA. 1988 Aug 19;260(7):929-34.
Although fatigue is one of the most common complaints in ambulatory care, research has been minimal. Of the 1159 consecutive patients surveyed in two adult primary-care clinics, 276 (24%) indicated that fatigue was a major problem. Fatigue was more prevalent in women than in men (28% vs 19%). Extensive clinical, laboratory, psychometric, and functional data were gathered for 102 fatigued patients and 26 controls. Laboratory testing was not useful in detecting unsuspected medical conditions or in determining the cause of fatigue. Depression or somatic anxiety or both were suggested by screening psychometric instruments in 82 fatigued patients (80%) compared with three controls (12%). Global dysfunction was marked, as reported by patients on the Sickness Impact Profile. The mean score on the Sickness Impact Profile of 11.3 for fatigued patients is similar to that reported for patients with major medical illnesses. After one year of follow-up, only 29 fatigued patients (28%) had improved. The high prevalence, persistence, and functional consequences of fatigue mandate a search for effective therapy.
尽管疲劳是门诊护理中最常见的主诉之一，但相关研究却很少。在两家成人初级保健诊所连续调查的1159名患者中，276名（24%）表示疲劳是一个主要问题。疲劳在女性中比男性更普遍（28%对19%）。为102名疲劳患者和26名对照者收集了广泛的临床、实验室、心理测量和功能数据。实验室检测对于发现未被怀疑的疾病状况或确定疲劳原因并无帮助。通过心理测量工具筛查，82名疲劳患者（80%）存在抑郁或躯体焦虑或两者皆有，而对照者中有3名（12%）。如患者在疾病影响量表上所报告的，整体功能障碍很明显。疲劳患者的疾病影响量表平均得分为11.3，与患有重大疾病的患者所报告的得分相似。经过一年的随访，只有29名疲劳患者（28%）有所改善。疲劳的高患病率、持续性和功能后果促使人们寻找有效的治疗方法。
