视神经脊髓炎患者疲劳与临床特点相关性研究

目的 研究视神经脊髓炎(neuromyelitis optica，NMO)患者疲劳和临床特点的关系。方法 对采用疲劳程度（fatigue impact scale,FIS）评分量表对我院已确诊为NMO的患者进行评分，并分析其疲劳程度与相关临床特点的关系。结果 64例符合NMO诊断的患者（平均年龄50.0岁，男性/女性:3/61）纳入研究，血清NMO-IgG阳性比例71.9%,43例（67.2%）NMO患者使用免疫抑制剂治疗。FIS-总评分结果平均值为:64.8±36.1，其中FIS-认知:13.2±8.5，FIS-生理:20.6±11.6,FIS-社会:31.0±18.7。免疫抑制剂使用组和非免疫抑制剂使用组其FIS-总（ P=0.294 9）、FIS-认知（ P=0.467 1）、FIS-生理（ P=0.472 2）、FIS-社会（ P=0.212 6）评分差异均无统计学意义。患者年龄、性别、血清NMO-IgG、病程、年复发率均不仅与FIS-总评分无相关性（ P>0.05），也与疲劳对认知（ P>0.05）、生理（ P>0.05）、社会功能（ P>0.05）3个方面的影响无相关性。扩展残疾状态量表评分与FIS-总（ P=0.000 5）、FIS-认知（ P=0.018 7）、FIS-生理（ P=0.000 4）、FIS-社会（ P=0.000 5）均呈正相关。发作次数与FIS-认知呈正相关（ P=0.007 9）。结论 NMO患者残疾状态同疲劳对生理、社会、认知功能的影响均呈正相关，发作次数同疲劳对认知功能的影响呈正相关。

Correlates of Fatigue in Patients with Neuromyelitis Optica

Objective To determine clinical characteristics associated with fatigue in patients with neuromyelitis optica (NMO). Methods A questionnaire survey was conducted in NMO patients, measuring fatigue using the fatigue impact scale (FIS). Results A total of 64 NMO patients (mean age: 50.0 years; male/female: 3/61) completed the survey: 71.9% were NMO-IgG seropositive and 43 (67.2%) received immunosuppressive treatments. The patients obtained a global FIS score of 64.8±36.1, with 13.2±8.5, 20.6±11.6 and 31.0±18.7 for the cognitive, physical and social dimensions, respectively. No significant differences were found in global FIS scores （ P=0.294 9）, and cognitive （ P=0.467 1）, physical （ P=0.472 2） and social （ P=0.212 6） dimensional scores between those with and without immunosuppressive treatments. Age, sex, serum NMO-IgG, duration of disease and annual relapse rates were neither correlated with global FIS scores （ P>0.05）, nor with the three dimensional scores （ P>0.05). The Expanded Disability Status Scale score was positively associated with global FIS scores （ P=0.000 5）and cognitive（ P=0.018 7）, physical（ P=0.000 4） and social （ P=0.000 5）dimensional scores. The frequency of attack was also positively correlated with cognitive dimensional scores （ P=0.007 9）.Conclusion Disability is associated with cognitive, physical and social dimensions of fatigue. High frequency of attack is positively correlated with the cognitive dimension of fatigues.