A comparison between long-term survivors of Hodgkin's disease and their siblings on fatigue level and factors predicting for increased fatigue
A comparison between long-term survivors of Hodgkin's disease and their siblings on fatigue level and factors predicting for increased fatigue
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DOI：
10.1093/annonc/mdi407
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发表时间：
2005-12-01
影响因子：
50.5
通讯作者：
Diller, L
中科院分区：
文献类型：
--
作者：
Ng, AK;Li, S;Diller, L
目的：比较霍奇金病患者及其同胞的疲劳程度，探讨疲劳增加的相关因素。方法：对确诊5年以上的霍奇金病患者及其同胞进行问卷调查。使用慢性病治疗-疲劳功能评估(Facit-F)工具测量疲劳程度，得分较低反映疲劳增加。结果：511名幸存者(中位年龄44岁，16-82岁)和224名兄弟姐妹(中位年龄44岁，16-79岁)收回了完整的调查问卷。有效率分别为61%和58%。与兄弟姐妹相比，幸存者报告心脏病(26%比16%；P=0.001)和甲状腺功能减退(65%比3%；P<；0.001)的可能性明显更大，平均Facit-F评分也明显更低(40.7和42.2；P=0.001)。在多变量分析中，与幸存者疲劳增加显著相关的因素是心脏病报告(P<；0.001)、精神状况(P<；0.001)、吸烟史(P=0.004)和运动频率低(P=0.03)。对于兄弟姐妹来说，与疲劳增加相关的唯一独立因素是低锻炼频率(P=0.03)。结论：霍奇金病幸存者比他们的兄弟姐妹更疲惫。这一差异不大，但在统计上意义重大。疲劳和心脏病之间的显著关联表明，对有疲劳症状的幸存者进行潜在心脏功能障碍筛查的重要性。疲劳和吸烟史之间的联系可能是由于吸烟加剧了霍奇金病的晚期医学并发症。
Purpose: To compare the level of fatigue in survivors of Hodgkin's disease and their siblings, and to explore factors associated with increased fatigue.Methods: Survivors of Hodgkin's disease 5 years or more from diagnosis and their siblings completed a questionnaire study. Fatigue level was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) instrument, with lower scores reflecting increased fatigue. Multiple regression models were used to identify factors associated with fatigue level in the two populations.Results: Five hundred and eleven survivors (median age 44 years; range 16-82) and 224 siblings (median age 44 years; range 16-79) returned the completed questionnaire. The response rates were 61% and 58%, respectively. Compared with siblings, survivors were significantly more likely to report the presence of cardiac disease (26% versus 16%; P = 0.001) and hypothyroidism (65% versus 3%; P < 0.001), and had a significantly lower mean FACIT-F score (40.7 and 42.2; P = 0.05). On multivariable analysis, factors significantly associated with increased fatigue in survivors were reports of cardiac disease (P < 0.001), psychiatric condition (P < 0.001), history of tobacco use (P = 0.004) and low exercise frequency (P = 0.03). For siblings, the only independent factor associated with increased fatigue was low exercise frequency (P = 0.03).Conclusions: Survivors of Hodgkin's disease were more fatigued than their siblings. The difference was modest but statistically significant. The significant association between fatigue and cardiac disease suggests the importance of screening for underlying cardiac dysfunction in survivors with symptoms of fatigue. The association between fatigue and smoking history may be due to exacerbation of late medical complications of Hodgkin's disease by tobacco use.