Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Department of Internal Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Int J Rheum Dis. 2022 Oct;25(10):1137-1144. doi: 10.1111/1756-185X.14391. Epub 2022 Jul 29.
Symptom cluster refers to a group of 3 or more related symptoms that occur together. Our objectives were to: (1) investigate the frequency, severity and gender difference of symptoms in patients with ankylosing spondylitis (AS); and (2) identify symptom clusters in AS patients. A cross-sectional questionnaire-based survey was conducted using the Patient Health Questionnaire Symptoms Group combined with self-designed variables. Demographic and symptom variables between male and female patients in terms of C-reactive protein (CRP) and human leukocyte antigen (HLA)-B27 status were analyzed with 2-tailed independent t test for continuous variables and Chi-square or Fisher's exact test for categorical variables. Symptom clusters were extracted and analyzed by principal component analysis. There were 122 AS patients included in the study. The most severe symptoms included severe back pain, extremity or joint pain, difficulty in breathing, constipation, intestine discomfort and diarrhea. Stomachache was more prevalent in male patients in which odds ratio was 4.60 (CI 1.59-12.97) (P = .006). Patients with HLA-B27 negativity or a higher CRP value were more likely to have dry mouth. Four symptom clusters were classified, which explained 58.4% of the total variation. They were named as the gastrointestinal-cardiac cluster, the fatigue-sleep disturbance cluster, the headache-chest pain cluster, and the mouth-eye cluster. The symptoms appeared to cluster into 4 groups in AS patients, which should be noticed in clinical care.
症状群是指同时出现的 3 个或更多相关症状。我们的目标是：（1）调查强直性脊柱炎（AS）患者症状的频率、严重程度和性别差异；（2）确定 AS 患者的症状群。采用患者健康问卷症状群与自行设计的变量相结合的横断面问卷调查方法进行研究。采用双侧独立 t 检验分析连续变量和卡方检验或 Fisher 确切概率法分析分类变量，比较 CRP 和 HLA-B27 状态下男女患者的人口统计学和症状变量。通过主成分分析提取和分析症状群。本研究共纳入 122 例 AS 患者。最严重的症状包括严重背痛、四肢或关节疼痛、呼吸困难、便秘、肠不适和腹泻。男性患者中腹痛更为常见，优势比为 4.60（95%CI 1.59-12.97）（P=0.006）。HLA-B27 阴性或 CRP 值较高的患者更可能出现口干。将 4 个症状群分类，解释了总变异的 58.4%。它们分别命名为胃肠道-心脏症状群、疲劳-睡眠障碍症状群、头痛-胸痛症状群和口腔-眼睛症状群。AS 患者的症状似乎分为 4 组，在临床护理中应予以关注。
