干燥综合征患者的疲乏状况及影响因素分析

Analysis of fatigue in patients with sjogren syndrome and its influencing factors

目的：本研究在调查干燥综合征患者疲乏现状的基础上,探讨不同睡眠质量、疾病状态及心理状态对干燥综合征患者疲乏的影响。方法本研究采用非实验研究中的描述性研究,便利抽取在江苏省两所三甲医院就诊建卡、确诊为干燥综合征且符合入选标准的135例患者进行问卷调查,以了解干燥综合征患者疲乏现状。研究所使用的问卷包括患者一般资料问卷、疲乏概况量表（ PROF）、匹兹堡睡眠质量指数问卷（ PSQI）、综合医院焦虑抑郁量表（ HADS）、干燥综合征疾病活动指数（ ESSDAI）。通过t检验、Pearson相关性分析、多元线性回归等统计学方法探讨影响患者疲乏的因素。结果56.1%的干燥综合征患者存在疲乏状况,PROF得分为（3.25±1.95）分,其中躯体疲乏得分为（3.45±2.07）分,精神疲乏得分为（2.67±2.09）分。多因素回归分析显示,干燥综合征相关疲乏的影响的因素依次是：睡眠状况、焦虑、疼痛、疾病活动度。结论医务人员应重视干燥综合征患者的睡眠质量,给予相应的睡眠指导和护理措施；在临床工作中不仅要治疗控制疾病的发展,缓解疼痛,还要重视患者的心理健康,并进行早期心理干预。

Objective To explore the effects of different sleep quality, morbid state and psychological status on the fatigue of patients with sjogren syndrome based on the comprehensively investigation of fatigue status in patiens with sjogren syndrome. Methods We adopted descriptive study of the non-experimental study, and selected 135 patients who were dignosed with sjogren syndrome, received treatment in two tertiary hospitals and met the inclusion criteria by convenience sampling method. Patients were surveyed by questionnaire package about the fatigue status. The questionnaire package included the general information questionnaire, Piper profile of fatigue （PROF）, Pittsburgh sleep quality index （PSQI）, hospital anxiety and depression scale （HADS）, and EULAR sjogren syndrome disease activity index （ESSDAI）. Statistical analyses including t-test, Pearson correlation analysis and multivariate linear regression were performed to explore the influencing factors of fatigue. Results 56.1% of the patients with sjogren syndrome had fatigue symptom, and the score of PROF was （3.25± 1.95）;while the score of PROF-somatic was （3.45±2.07） and the score of PROF-mental was （2.67±2.09）. Multivariate regression analysis showed that： sleep status, anxiety, pain, ESSDAI were influencing factors of fatigue. Conclusions Rheumatology medical personnel should pay attention to the sleep quality of patients with sjogren syndrome, and give corresponding sleep guidance and nursing measures. In the clinical work, we should not only control the progress of disease, relievie pain, but also attach great importance to the patient′s mental health and early psychological intervention.