McKinley P S, Ouellette S C, Winkel G H
Graduate Center of the City University of New York, NY 10036, USA.
Arthritis Rheum. 1995 Jun;38(6):826-34. doi: 10.1002/art.1780380617.
This study describes lupus fatigue multidimensionally and introduces a multivariate model: Sleep problems and depression, through reciprocal effects on each other, act as mediators through which lupus disease activity increases fatigue.
Self-reported sleep patterns, depression, and fatigue were assessed in 48 women with systemic lupus erythematosus (SLE) and 27 women from the general population. Rheumatologists rated current lupus disease activity.
The SLE group reported greater overall fatigue than did the controls. Temporal and affective dimensions of fatigue were more differentiating than sensory or severity dimensions. The SLE group also reported longer sleep latency and total sleep time, but not higher depression. Using 2-stage regression, a form of structural equation modeling, the proposed lupus fatigue model was supported.
These preliminary results describe fatigue as a multidimensional phenomenon arising out of several contributing factors. They suggest that fatigue treatment strategies should address mediating processes such as sleep and depression, in addition to disease activity.
本研究从多维度描述狼疮性疲劳，并引入一个多变量模型：睡眠问题和抑郁通过相互影响，作为狼疮疾病活动增加疲劳的中介因素。
对48名系统性红斑狼疮（SLE）女性患者和27名普通人群女性的自我报告睡眠模式、抑郁和疲劳情况进行评估。风湿病学家对当前狼疮疾病活动进行评分。
SLE组报告的总体疲劳程度高于对照组。疲劳的时间维度和情感维度比感觉维度或严重程度维度更具区分性。SLE组还报告了更长的睡眠潜伏期和总睡眠时间，但抑郁程度并未更高。使用两阶段回归（一种结构方程建模形式），所提出的狼疮性疲劳模型得到了支持。
这些初步结果将疲劳描述为由多种促成因素产生的多维度现象。它们表明，除了疾病活动外，疲劳治疗策略还应针对睡眠和抑郁等中介过程。
