Acute infectious mononucleosis: Characteristics of patients who report failure to recover
Acute infectious mononucleosis: Characteristics of patients who report failure to recover
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DOI：
10.1016/s0002-9343(00)00560-x
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发表时间：
2000-11-01
影响因子：
5.9
通讯作者：
Ashley, RL
中科院分区：
文献类型：
--
作者：
Buchwald, DS;Rea, TD;Ashley, RL
目得：我们试图确定如何经常急性单核细胞增多症沉淀慢性疾病，并描述人口统计学，临床和心理社会特征的特点，患者报告失败recover.SUBJECTS和方法：我们招募了150例传染性单核细胞增多症的急性疾病，并要求他们评估他们的恢复在2个月和6个月。在基线，我们进行了身体和实验室检查，获得的心理和躯体功能，社会支持，生活事件的措施，并管理一个结构化的精神interviews.Results：自我评估失败，以恢复38%的患者（55 144）在2个月和12%（17 142）在6个月。那些没有康复的人报告了一种以疲劳和功能状态差为特征的持续性疾病。没有客观的疾病指标，包括体格检查结果或血清学或实验室标志物，区分未能恢复的患者和报告恢复的患者。2个月时无法恢复的基线预测因素是年龄较大（比值比[OR] = 1.4，95%置信区间[CI]：1.1至1.8，每5年增加），温度升高（OR = 1.5，95% CI：1.1 - 2.2，每升高0.5 ℃），由于身体功能，角色限制更大（OR = 1.5，95% CI：1.2 - 1.9，简表-36评分每降低20分）。在6个月时，无法恢复的基线预测因素包括女性（OR = 3.3，95%CI：1.0 ~ 12），发病前6个月以上发生的生活事件较多（OR = 1.7，95% CI：1.1至2.5，每增加一个生活事件），以及更多的家庭支持（OR = 1.9，95%CI：1.1 ~ 4.2，社会支持评分每增加7分）.结论：我们无法确定以自我报告未能从急性传染性单核细胞增多症中恢复为特征的客观指标。与自我报告的2个月时未能恢复相关的基线因素与6个月时未能恢复相关的基线因素不同。未来的研究应该评估这些发现的普遍性，并确定干预措施是否可以加速恢复。美国医学杂志2000;109：531-537。(C)2000年出版，Excerpta Medica，Inc.
PURPOSE: We sought to determine how often acute mononucleosis precipitates chronic illness, and to describe the demographic, clinical, and psychosocial features that characterize patients who report failure to recover.SUBJECTS AND METHODS: We enrolled 150 patients with infectious mononucleosis during the acute illness and asked them to assess their recovery at 2 and 6 months. At baseline, we performed physical and laboratory examinations; obtained measures of psychological and somatic functioning, social support, and life events; and administered a structured psychiatric interview.RESULTS: Self-assessed failure to recover was reported by 38% of patients (55 of 144) at 2 months and by 12% (17 of 142) at 6 months. Those who had not recovered reported a persistent illness characterized by fatigue and poor functional status. No objective measures of disease, including physical examination findings or serologic or laboratory markers, distinguished patients who failed to recover from those who reported recovery. Baseline predictors for failure to recover at 2 months were older age (odds ratio [OR] = 1.4, 95% confidence interval [CI]: 1.1 to 1.8, per 5-year increase), higher temperature (OR = 1.5, 95% CI: 1.1 to 2.2, per 0.5 degreesC increase), and greater role limitation due to physical functioning (OR = 1.5, 95% CI: 1.2 to 1.9, per 20-point decrease in Short Form-36 score). At 6 months, baseline predictors for failure to recover included female sex (OR = 3.3, 95% CI: 1.0 to 12), a greater number of life events more than 6 months before the disease began (OR = 1.7, 95% CI: 1.1 to 2.5, per each additional life event), and greater family support (OR = 1.9, 95% CI: 1.1 to 4.2, per 7-point increase in social support score).CONCLUSIONS: We were not able to identify objective measures that characterized self-reported failure to recover from acute infectious mononucleosis. The baseline factors associated with self-reported failure to recover at 2 months differed from those associated with failure to recover at 6 months. Future studies should assess the generalizability of these findings and determine whether interventions can hasten recovery. Am J Med. 2000;109:531-537. (C) 2000 by Excerpta Medica, Inc.