Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Division of Rheumatology, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada.
Lupus Sci Med. 2024 Jul 11;11(2):e001006. doi: 10.1136/lupus-2023-001006.
To determine if self-reported fatigue, anxiety, depression, cognitive difficulties, health-related quality of life, disease activity scores and neuropsychological battery (NB) cluster into distinct groups in patients with SLE based on symptom intensity and if they change at 1-year follow-up.
This is a retrospective analysis of consecutive consenting patients, followed at a single centre. Patients completed a comprehensive NB, the Beck Anxiety Inventory, Beck Depression Inventory, Fatigue Severity Scale, Short-Form Health Survey Physical Component Summary and Mental Component Summary scores and the Perceived Deficits Questionnaire. Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index 2000. Ward's method was used for clustering and principal component analysis was used to visualise the number of clusters. Stability at 1 year was assessed with kappa statistic.
Among 142 patients, three clusters were found: had mild symptom intensity, had moderate symptom intensity and had severe symptom intensity. At 1-year follow-up, 49% of patients remained in their baseline cluster. The mild cluster had the highest stability (77% of patients stayed in the same cluster), followed by the severe cluster (51%), and moderate cluster had the lowest stability (3%). A minority of patients from mild cluster moved to severe cluster (19%). In severe cluster, a larger number moved to moderate cluster (40%) and fewer to mild cluster (9%).
Three distinct clusters of symptom intensity were documented in patients with SLE in association with cognitive function. There was a lower tendency for patients in the mild and severe clusters to move but not moderate cluster over the course of a year. This may demonstrate an opportunity for intervention to have moderate cluster patients move to mild cluster instead of moving to severe cluster. Further studies are necessary to assess factors that affect movement into moderate cluster.
确定基于症状强度，是否在系统性红斑狼疮（SLE）患者中，自我报告的疲劳、焦虑、抑郁、认知困难、健康相关生活质量、疾病活动评分和神经心理成套测验（NB）聚类为不同组，如果在 1 年随访时它们是否会发生变化。
这是对在单中心接受连续同意的患者进行的回顾性分析。患者完成了综合 NB、贝克焦虑量表、贝克抑郁量表、疲劳严重程度量表、简明健康调查问卷（SF-36）物理成分综合和精神成分综合评分以及感知缺陷问卷。疾病活动通过系统性红斑狼疮疾病活动指数 2000 进行评估。采用 Ward 法进行聚类，采用主成分分析来可视化聚类的数量。使用 Kappa 统计评估 1 年时的稳定性。
在 142 名患者中，发现了三个聚类：聚类 患者的症状强度较轻，聚类 患者的症状强度为中度，聚类 患者的症状强度为重度。在 1 年随访时，49%的患者仍处于基线聚类。轻度聚类的稳定性最高（77%的患者留在同一聚类），其次是重度聚类（51%），中度聚类的稳定性最低（3%）。少数轻度聚类的患者转移到重度聚类（19%）。在重度聚类中，更多的患者转移到中度聚类（40%），而转移到轻度聚类的患者较少（9%）。
在 SLE 患者中记录了三个不同的症状强度聚类，与认知功能有关。在轻度和重度聚类的患者中，倾向于保持不变，但在中度聚类的患者中，倾向于移动的较少。这可能表明有机会进行干预，使中度聚类的患者转移到轻度聚类，而不是转移到重度聚类。需要进一步研究来评估影响进入中度聚类的因素。
