Tecer Duygu, Eker Büyüksireci Dilek, Günedi Zafer, Meray Jale, Göğüs Feride
Department of Internal Medicine, Division of Rheumatoloy, Health Sciences University, Gülhane Education and Research Hospital, Ankara, Türkiye.
Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Hitit University Erol Olçok Training and Research Hospital, Çorum, Türkiye.
Arch Rheumatol. 2022 Sep 20;38(1):101-108. doi: 10.46497/ArchRheumatol.2023.9414. eCollection 2023 Mar.
This study aims to investigate skeletal muscle architecture and strength in patients with primary Sjögren syndrome (pSS).
Between July 01, 2017 and November 30, 2017, 19 pSS patients (19 females; mean age: 54.1±6.6 years; range, 42 to 62 years) and 19 age-, body mass index-, and sex-matched healthy controls (19 females; mean age: 53.2±6.7 years; range 42 to 61 years) were included. Sjögren symptoms were assessed with the European Alliance of Associations for Rheumatology (EULAR) Sjögren's Syndrome Patient Reported Index (ESSPRI). Muscle thickness, pennation angle, and fascicle length were measured at quadriceps femoralis, gastrocnemius and soleus muscles. Isokinetic muscle strength tests were performed at 60 and 180°/sec for knee and at 30 and 120°/sec for ankle. Anxiety and depression evaluated with the Hospital Anxiety and Depression Scale (HADS), fatigue with Multidimensional Assessment of Fatigue scale (MAF), and functionality with Health Assessment Questionnaire (HAQ).
In the pSS group, the mean ESSPRI was 7.70±1.17. The mean scores of depression (10.05±3.09 4.47±2.29; p<0.0001), anxiety (8.26±4.28 3.79±2.42; p<0.0001), functionality (0.94±0.78 0.22±0.26; p<0.0001), and fatigue (37.69±5.47 17.69±5.26; p<0.0001) were significantly higher in patients with pSS. Only, the pennation angle of vastus medialis in dominant leg was significantly greater in healthy controls (p=0.049). Peak torques/body weight of knee and ankle muscles were found to be similar.
Excluding a minor decrease of the pennation angle at vastus medialis, muscle structure of lower extremity of pSS patients were similar to healthy controls. In addition, isokinetic muscle strength did not significantly differ in patients with pSS compared to healthy controls. In patients with pSS, disease activity and fatigue level were negatively correlated with isokinetic muscle strength measurements.
本研究旨在调查原发性干燥综合征（pSS）患者的骨骼肌结构和力量。
2017年7月1日至2017年11月30日期间，纳入了19例pSS患者（19名女性；平均年龄：54.1±6.6岁；范围42至62岁）和19名年龄、体重指数和性别匹配的健康对照者（19名女性；平均年龄：53.2±6.7岁；范围42至61岁）。使用欧洲抗风湿病联盟（EULAR）干燥综合征患者报告指数（ESSPRI）评估干燥综合征症状。测量股四头肌、腓肠肌和比目鱼肌的肌肉厚度、羽状角和肌束长度。在膝关节以60°/秒和180°/秒、踝关节以30°/秒和120°/秒进行等速肌力测试。使用医院焦虑抑郁量表（HADS）评估焦虑和抑郁，使用疲劳多维评估量表（MAF）评估疲劳，使用健康评估问卷（HAQ）评估功能。
在pSS组中，ESSPRI的平均值为7.70±1.17。pSS患者的抑郁（10.05±3.09对4.47±2.29；p<0.0001）、焦虑（8.26±4.28对3.79±2.42；p<0.0001）、功能（0.94±0.78对0.22±0.26；p<0.0001）和疲劳（37.69±5.47对17.69±5.26；p<0.0001）的平均得分显著更高。仅优势腿股内侧肌的羽状角在健康对照者中显著更大（p=0.049）。发现膝关节和踝关节肌肉的峰值扭矩/体重相似。
除股内侧肌羽状角略有减小外，pSS患者下肢的肌肉结构与健康对照者相似。此外，与健康对照者相比，pSS患者的等速肌力没有显著差异。在pSS患者中，疾病活动度和疲劳水平与等速肌力测量值呈负相关。
