类风湿关节炎患者疲劳现状及其影响因素分析

An analysis of fatigue status and its influencing factors in patients with rheumatoid arthritis

目的分析类风湿关节炎(RA)患者疲劳现状及其影响因素。方法RA患者197例,根据疲劳严重程度量表(FSS)分为A组(FSS评分≥4分,113例)和B组(FSS评分<4分,84例),采用健康评估问卷(HAQ)、健康调查简表(SF-36)以及VAS疼痛评分对患者进行评估,采用Spearman相关分析FSS评分与其他指标的相关性,采用多因素logistic回归分析RA患者疲劳的影响因素。结果RA患者FSS评分为4.56(2.56,6.00)分。与B组比较,A组患者病程、关节疼痛持续时间和每日晨僵时间较长,VAS疼痛评分较高,肿胀关节计数较多,RA病情活动度评价表(DAS28)评分和HAQ评分较高,SF-36评分较低(P<0.05)。Spearman相关分析显示,FSS评分与年龄、病程、关节疼痛持续时间、每日晨僵时间、疼痛关节计数、肿胀关节计数、VAS疼痛评分、DAS28评分及HAQ评分呈正相关(P<0.05),与SF-36评分呈负相关(P<0.05)。多因素logistic回归分析显示,病程较长、HAQ评分较低和SF-36评分较低是RA患者FSS评分的独立危险因素(P<0.05)。结论RA患者的疲劳状况欠佳,病程较长、躯体功能状态差和生活质量低的患者更容易发生疲劳。

Objective To analyze the fatigue status and its influencing factors in the patients with rheumatoid arthritis(RA).Methods According to fatigue severity scale(FSS),197patients with RA were divided into two groups of A(FSS score≥4points,113cases)and B(FSS score<4 points,84cases).The health assessment questionnaire(HAQ),the MOS item short from health survey(SF-36)and VAS pain score were assessed in the two groups.The correlation between FSS score and other indicators was analyzed by Spearman correlation analysis.The influencing factors for fatigue in RA patients were analyzed by multivariate logistic regression.Results The FSS score of RA patients was 4.56(2.56,6.00)points.Compared with group B,the patients in group A had longer course of disease,duration of joint pain and daily morning stiffness time,higher VAS pain score,more swelling joint counts,higher DAS28score and HAQ score,and lower SF-36score(P<0.05).Spearman correlation analysis showed that FSS score was positively correlated with age,course of disease,duration of joint pain,daily morning stiffness time,painful joint count,swelling joint count,VAS pain score,DAS28score and HAQ score,and negatively correlated with SF-36score(P<0.05).Multivariate logistic regression analysis showed that longer course of disease,lower HAQ score,and lower SF-36score were the independent risk factors for FSS score in RA patients(P<0.05).Conclusion The fatigue status of RA patients is poor,and the patients with longer course of disease,poor physical function status and lower quality of life are more prone to fatigue.