多发性硬化患者的疲劳状况及其影响因素

摘要

目的：调查多发性硬化（MS）患者的疲劳状况并探讨其影响因素。方法：应用修订的疲劳影响量表（MFIS）、疾病相关因素资料及一般情况登记表，对99例MS患者进行面对面问卷式调查，收集人口统计学特征、MS疾病相关信息、疲劳程度、抑郁程度及对生存质量的影响等临床资料，采用SPSS15.0软件统计分析其影响因素。结果：性别、年龄、复发次数与疲劳发生率无统计学相关（P＞0.05）；病程、残疾程度和抑郁程度3个变量与疲劳发生率呈独立相关（P＜0.05）。病程为5～10年的患者疲劳发生率为病程≤5年的患者的4.76倍，中重度残疾患者疲劳发生率为轻度残疾患者的10.81倍，抑郁程度每上升一个等级，疲劳发生率会增加2.32倍；疲劳患者的生存质量方面无论是躯体还是心理症状得分均明显高于未发生疲劳的患者，差异有统计学意义（P＜0.01）。结论：病程、残疾程度和抑郁程度均为MS相关性疲劳的影响因素，与疲劳程度呈正相关。疲劳对生存质量影响明显。%Objective: To study fatigue condition and discuss its inlfuencing factors in multiple sclerosis (MS) patients.Methods: The modiifed fatigue impact scale (MFIS), data of disease-related factors and general proifle registration form were used to conduct a face-to-face questionnaire investigation in 99 MS patients to col-lect demographic characteristics, MS-related information, fatigue degree, depression degree, impacts on quality of life (QOL) and other clinical data. SPSS15.0 software was then used for statistical analysis of the inlfuencing factors.Results: Gender, age and relapse amount showed no statistical correlation with occurrence of fatigue (P>0.05); three variables, including disease course, disability level and depression degree were independently correlated with occurrence of fatigue. The fatigue occurrence in patients with a disease course of 5-10 years is 4.76 times of that in patients with a disease course≤5 years; the fatigue occurrence in moderately and severely dis-abled patients was 10.81 times of that in mildly disabled patients; and the occurrence of fatigue increases for 2.32 times if the depression degree increases for one scale. With respect to QOL, scores of both physical and psycho-logical symptoms in patients with fatigue were higher than those in patients without fatigue, showing statistically signiifcant differences (P<0.01).Conclusion: MS patients with long disease course, disability and severe depres-sion degree have severer fatigue and fatigue poses obvious impacts on QOL. Disease course, disability level and depression degree are all inlfuencing factors for MS-related fatigue.