类风湿关节炎患者疲乏症状与疾病活动及生活质量关系的研究

目的 评价类风湿关节炎(RA)患者疲乏症状的发生率,并探讨疲乏与疾病活动、功能状态及生活质量的关系.方法 入选RA患者230例,应用疲乏目视模拟测试表(VAS)评分评估患者疲乏的发生率,探讨疲乏评分≥50 mm和<50 mm的RA患者临床指标、疾病活动、功能状态、生活质量及实验室炎性指标的变化,并对疲乏的相关因素进行分析.结果 85.7%的RA患者疲乏VAS评分≥20 mm,51.7%的患者疲乏VAS评分≥50 mm.疲乏评分≥50 mm的患者与<50 mm的患者相比,晨僵时间、疼痛VAS评分、患者对自身健康状况的总体评估(PGA)、医生总体评价、压痛关节数(TJC)、压痛关节指数(TJI)、肿胀关节数(SJC)、肿胀关节指数(SJI)、疾病活动指数28(DAS28)、健康评估问卷(HAQ)得分及红细胞沉降率(ESR)明显增高,而健康测量量表SF-36中有关生理和心理健康8个维度得分明显降低,差异均有统计学意义.双变量相关分析显示:疲乏与晨僵时间、疼痛VAS评分、PGA、医生总体评价、TJC、TJI、SJC、SJI、DAS28、HAQ及SF-36中有关生理和心理健康的8个维度均有低至中等程度的相关性,与ESR、C反应蛋白(CRP)之间具有较弱的相关性.结论 疲乏是RA患者的一个重要症状,并与患者疼痛、疾病活动、功能状态及生活质量相关.

Assessment of fatigue in patients with rheumatoid arthritis: relation with disease activity and healthrelth-related quality of life

Objective To investigate the prevalence of fatigue in rheumatoid arthritis (RA) and its relationship with other clinical and functional parameters used for the evaluation of disease activity and health related quality of life. Methods The fatigue was assessed in 230 patients with RA using visual analogue scale (VAS). The correlation between fatigue and the clinical disease activity including morning stiffness, pain, PGA, physician's global assessment, TJC, TJI, SJC, SJI, DAS28, HAQ and health-related quality of life were assessed. Results The prevalence of fatigue was 85.7% and the fatigue score of 51.7% patients was higher than 50 mm. After controlled for the possible confounding factors such as age, gender and disease duration, it was found that fatigue was highly correlated with pain, disease activity, functional disability, physical health and mental health. Conclusion Fatigue is an important symptom of RA and is correlated with pain, disease activity, functional disability and health-related quality of life.