成人原发免疫性血小板减少症患者疲劳症状及影响因素分析

Predictors of fatigue among individuals with primary immune thrombocytopenia in China

目的研究成人原发免疫性血小板减少症（ITP）患者疲劳症状，分析疲劳严重程度的影响因素。方法采用中文版慢性病治疗功能评估疲乏量表（FACIT疲劳量表）、匹兹堡睡眠质量指数（PSQI）、医院焦虑抑郁量表（HADS）及一般情况调查表对就诊于中国医学科学院血液病医院的成人ITP患者进行调查研究，运用多元线性回归分析方法筛选影响疲劳严重程度的相关因素。结果共纳入207例ITP患者，中位年龄42（18-72）岁，男70例（33.8%），女137例（66.2%），总体FACIT疲劳量表得分为（37.50±9.05）分。ITP患者FACIT疲劳量表得分与血小板计数呈正相关（r= 0.307，P〈0.001），与出血严重程度、睡眠质量、抑郁情绪、焦虑情绪呈负相关（r值分别为-0.276、-0.654、-0.598、-0.616，P值均〈0.001）。多因素线性回归分析显示，血小板计数（P〈0.001）、出血程度（P=0.004）、睡眠质量（P〈0.001）、抑郁情绪（P〈0.001）与ITP患者的疲劳严重程度显著相关，血小板计数偏低、出血程度越重、睡眠质量越差、抑郁情绪越明显，提示疲劳程度越严重。结论ITP患者的疲劳症状受多种因素影响，改善睡眠质量、消除抑郁情绪、提高血小板数目、改善出血症状等措施有助于缓解疲劳程度。

ObjectiveTo study the fatigue symptoms of adult patients with primary immune thrombocytopenia （ITP） and to analyze the possible factors that affect the severity of fatigue.MethodsEligible adult patients with ITP who admitted to Institute of Hematology ＆ Blood Diseases Hospital were enrolled in this study and the questionnaires including a Chinese version of the Functional Assessment of Chronic Illness Therapy-Fatigue （FACIT-Fatigue） , the Pittsburgh sleep quality index （PSQI） , the Hospital Anxiety and Depression scale （HADS） and demographic information were completed. The predictors of fatigue were determined with multiple linear regression analyses.ResultsA total of 207 patients with ITP were enrolled, including 70 males （33.8%） and 137 females （66.2%） , the median age was 42 （18-72） years old. The FACIT-F score in ITP patients was （37.50±9.05） . The FACIT-F severity of ITP patients was positively correlated with the platelet count （r=0.307, P〈0.001） . The FACIT-F severity was negatively correlated with bleeding severity （r=-0.276, P〈0.001） , sleep quality （r=-0.654, P〈0.001） , depression （r=-0.598, P〈0.001） and anxiety （r=-0.616, P〈0.001） . A multiple linear regression analysis revealed that the severity of ITP-related fatigue was significantly correlated with platelet count （P〈0.001） , bleeding severity （P=0.004） , sleep quality （P〈0.001） and depression （P〈0.001） .ConclusionFatigue was determined by complicated factors in adult ITP patients. Interventions addressing depressive symptoms, sleep quality, bleeding symptoms and platelet count could be potential avenues for treatment of fatigue in patients with ITP.