摘要
背景:对于结节病患者日常生活中的身体活动了解甚少。疲劳是一种常见的致残症状,可能会对身体活动水平产生负面影响。
方法:我们用加速测量法(SenseWear臂带)测量结节病患者一周的体力活动(每日步数,SPD)。我们评估了肺功能(DLCO、FVC)、运动能力(6分钟步行距离、6分钟步行距离)、与健康相关的生活质量(SGRQ)、一般生活质量(SF-12)和疲劳(MFI-20)。
结果:我们调查了57例结节病患者(平均年龄50岁,56%男性,平均DLCO 73%pred)。,平均FVC 91%pred。,mean 6MWD 525m, mean SPD 7,490) of whom n=14 (25%) had severe fatigue. MFI-20 subscales ‘reduced activity’ and ‘physical fatigue’ were weakly associated with SPD on a bivariate level (Spearman-rho=-0.27, and -0.28; p<0.05), while other subscales and the total score were not. 6MWD, SGRQ, and SF-12 (physical health) showed stronger associations with SPD in bivariate analyses (Pearson r=0.50, r=-0.39, and r=0.47; p<0.01), and were independent predictors of SPD in multivariate analyses adjusting for confounders (p<0.05). 6MWD, SGRQ, and SF-12, identified sedentary patients (SPD<5,000) reasonably well by ROC curve analyses (AUROC 0.90, 0.81, 0.80; p<0.01). MFI-20 subscale ‘general fatigue’ was less predictive (AUROC 0.70;p=0.03).
结论:虽然运动能力和生活质量的测量均结节病患者的身体活动的稳健预测,疲劳客观测量身体活动的协会被意外疲弱。在结节病,疲劳可能不排除从身体活动受影响的病人,虽然这种症状主观感知为高度致残。
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