School of Nursing, Anhui Medical University, Hefei, 230601, Anhui, China.
Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
Rheumatol Int. 2024 Oct;44(10):2147-2157. doi: 10.1007/s00296-024-05690-6. Epub 2024 Aug 17.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects women of childbearing age and has been reported to cause sexual dysfunction in women. Although there are articles on sexual function in women with SLE, the number of articles is small, and the factors affecting sexual function in women with SLE are controversial. Based on this, this study aimed to investigate the prevalence of sexual dysfunction in Chinese female SLE patients and to explore the factors that influence it. The study design was a cross-sectional study conducted from December 2023 to April 2024 in the Department of Rheumatology and Immunology of a tertiary hospital in Hefei, Anhui Province. A total of 293 female patients diagnosed with SLE were enrolled using face-to-face questionnaires and online questionnaires. The questionnaire consisted of four parts: general information questionnaire, fatigue severity scale (FSS), depression-anxiety-stress scale (DASS-21), and female sexual functioning index (FSFI) scale. A total of 173 (59.04%) patients had sexual dysfunction, including 251 (85.67%) with decreased libido and 186 (63.46%) with difficulty in sexual arousal. There was a correlation between the patients' total FSFI scores and age (p = 0.028), marital satisfaction (p < 0.001), own education level (p = 0.008), partner's education level (p = 0.003), place of residence (p = 0.039), monthly household income (p < 0.001), family financial satisfaction(p < 0.001), menstrual status (p = 0.003), hormone use (p = 0.021),immunosuppressant use (p = 0.042), disease activity (p = 0.016), FSS score (p < 0.001), stress score (p < 0.001), anxiety score (p < 0.001) and depression score (p < 0.001)were correlated. The results of stepwise regression analysis showed that marital satisfaction (b = 2.011, t = 3.797, p < 0.001), monthly household income (b = 0.854, t = 2.316, p = 0.021), menstrual status (b = 1.218, t = 2.350, p = 0.019), fatigue scale score (b = - 0.069, t = - 2.302, p = 0.022), and depression score (b = - 0.117, t = - 2.910, p = 0.004) were the influencing factors of FSFI total score, and the difference was statistically significant. The incidence of sexual dysfunction in Chinese female SLE patients is high, and medical personnel should pay more attention to patients' sexual problems, to provide theoretical and practical bases for further prevention, treatment, and care of sexual dysfunction in female SLE patients.
系统性红斑狼疮（SLE）是一种慢性自身免疫性疾病，影响育龄妇女，据报道可导致女性性功能障碍。虽然有关于 SLE 女性性功能的文章，但数量较少，并且影响 SLE 女性性功能的因素存在争议。基于此，本研究旨在调查中国女性 SLE 患者性功能障碍的患病率，并探讨影响其的因素。研究设计为 2023 年 12 月至 2024 年 4 月在安徽省合肥市一家三级医院风湿病免疫科进行的横断面研究。使用面对面问卷和在线问卷共纳入 293 名确诊为 SLE 的女性患者。问卷包括四部分：一般信息问卷、疲劳严重程度量表（FSS）、抑郁-焦虑-压力量表（DASS-21）和女性性功能指数（FSFI）量表。共有 173 名（59.04%）患者存在性功能障碍，包括 251 名（85.67%）性欲减退和 186 名（63.46%）性唤起困难。患者的总 FSFI 评分与年龄（p=0.028）、婚姻满意度（p<0.001）、自身教育水平（p=0.008）、伴侣教育水平（p=0.003）、居住地（p=0.039）、月家庭收入（p<0.001）、家庭经济满意度（p<0.001）、月经状况（p=0.003）、激素使用（p=0.021）、免疫抑制剂使用（p=0.042）、疾病活动度（p=0.016）、FSS 评分（p<0.001）、压力评分（p<0.001）、焦虑评分（p<0.001）和抑郁评分（p<0.001）呈相关性。逐步回归分析结果显示，婚姻满意度（b=2.011，t=3.797，p<0.001）、月家庭收入（b=0.854，t=2.316，p=0.021）、月经状况（b=1.218，t=2.350，p=0.019）、疲劳量表评分（b=-0.069，t=-2.302，p=0.022）和抑郁评分（b=-0.117，t=-2.910，p=0.004）是 FSFI 总分的影响因素，差异有统计学意义。中国女性 SLE 患者性功能障碍的发生率较高，医务人员应更加关注患者的性问题，为进一步预防、治疗和护理女性 SLE 患者的性功能障碍提供理论和实践基础。
