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在炎症性肠病缓解期的患者中,疲劳与焦虑和较低的健康相关生活质量相关。

Fatigue Is Associated with Anxiety and Lower Health-Related Quality of Life in Patients with Inflammatory Bowel Disease in Remission.

机构信息

Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Gastroenterology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania.

出版信息

Medicina (Kaunas). 2023 Mar 9;59(3):532. doi: 10.3390/medicina59030532.

Abstract

Inflammatory bowel diseases (IBD) are chronic conditions with an unpredictable course and a remitting-relapsing evolution. Fatigue is a frequent complaint in patients with IBD, affecting approximately half of the newly diagnosed patients with IBD. The aim of this study was to analyze fatigue in patients with IBD in remission. One hundred nineteen consecutive outpatients diagnosed with IBD for over 3 months that were in corticosteroid-free clinical and biochemical remission at the time of assessment were included in this cross-sectional study. Out of them, 72 (60.5%) were male; the median age was 39 years (IQR 30-47). Seventy-seven patients (64.7%) were diagnosed with Crohn's disease and forty-two (35.3%) with ulcerative colitis, with a median disease duration of 6 years (IQR 2-10). Fatigue, health-related quality of life (HR-QoL), anxiety and depression were evaluated using the following self-administered questionnaires: FACIT Fatigue, IBDQ 32 and HADS. The mean FACIT-Fatigue score was 41.6 (SD ± 8.62), and 38.7% of patients were revealed as experiencing fatigue when a cut-off value of 40 points was used. The mean IBDQ 32 score was 189.4 (SD ± 24.1). Symptoms of anxiety and depression were detected in 37% and 21% of the patients, respectively. In the multivariate analysis, fatigue was significantly associated with lower HR-QoL (OR 2.21, 95% CI: 1.42-3.44, < 0.001), symptoms of anxiety (OR 5.04, 95% CI: 1.20-21.22, = 0.008), female sex (OR 3.32, 95% CI: 1.02-10.76, = 0.04) and longer disease duration (OR 1.13, 95% CI: 1.01-1.27, = 0.04). Fatigue is highly prevalent even in patients with inactive IBD and is correlated with lower HR-QoL and anxiety, as well as with clinical factors such as longer disease duration and female sex.

摘要

炎症性肠病(IBD)是一种具有不可预测病程和缓解-复发演变的慢性疾病。疲劳是 IBD 患者的常见主诉,大约有一半的新诊断为 IBD 的患者会出现疲劳。本研究旨在分析缓解期 IBD 患者的疲劳情况。

本横断面研究纳入了 119 例连续门诊诊断为 IBD 且超过 3 个月、在评估时处于无皮质类固醇的临床和生化缓解的患者。其中,72 例(60.5%)为男性;中位年龄为 39 岁(IQR 30-47)。77 例(64.7%)患者被诊断为克罗恩病,42 例(35.3%)为溃疡性结肠炎,中位疾病病程为 6 年(IQR 2-10)。使用以下自我管理问卷评估疲劳、健康相关生活质量(HR-QoL)、焦虑和抑郁:FACIT 疲劳量表、IBDQ 32 和 HADS。

FACIT 疲劳量表的平均得分为 41.6(SD ± 8.62),当使用 40 分的截断值时,38.7%的患者出现疲劳。IBDQ 32 的平均得分为 189.4(SD ± 24.1)。37%和 21%的患者分别出现焦虑和抑郁症状。在多变量分析中,疲劳与较低的 HR-QoL(OR 2.21,95%CI:1.42-3.44,<0.001)、焦虑症状(OR 5.04,95%CI:1.20-21.22, = 0.008)、女性(OR 3.32,95%CI:1.02-10.76, = 0.04)和更长的疾病病程(OR 1.13,95%CI:1.01-1.27, = 0.04)显著相关。即使在无活动 IBD 的患者中,疲劳也很常见,与较低的 HR-QoL 和焦虑相关,以及与疾病病程较长和女性等临床因素相关。

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