Determinants and impact of fatigue in patients with chronic obstructive pulmonary disease
Determinants and impact of fatigue in patients with chronic obstructive pulmonary disease
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DOI：
10.1016/j.rmed.2008.09.022
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发表时间：
2009-02-01
影响因子：
4.3
通讯作者：
Wedzicha, Jadwiga A.
中科院分区：
文献类型：
--
作者：
Baghai-Ravary, Ramin;Quint, Jennifer K.;Wedzicha, Jadwiga A.
理由：慢性阻塞性肺病患者的疲劳感与健康状况下降有关。我们已经证明，病情加重与活动减少和健康状况有关。然而，疲劳与恶化之间的关系尚不清楚。目的：调查疲劳增加与身体活动不足和慢性阻塞性肺病恶化有关的假设。方法：对慢性阻塞性肺病和年龄匹配的对照受试者的疲劳进行研究。评估疲劳与 COPD 稳定患者特征之间的关系，以及恶化对疲劳的影响。测量：107 名 COPD 患者平均年龄 69 岁（范围 43-86），FEV1 53%（SD 21），以及 30 名年龄匹配的对照受试者；慢性病治疗功能评估-疲劳量表、流行病学研究中心抑郁量表。主要结果：与对照受试者相比，COPI) 患者的疲劳显着增加（平均 35.3 单位 (SD 11.0) 对比 43.2 (SD 10.5)，p = 0.001）。 COPD 疲劳程度的增加与户外活动时间减少 (r = -0.43, p < 0.001)、抑郁程度增加 (r = -0.59, p < 0.001) 和每年恶化频率 (r = -0.27, p = 0.005) 有关。 31/32 的患者在病情恶化时疲劳加剧。总体而言，疲劳增加了 8.3 个单位 (5.9)，p < 0.001。恶化时疲劳的变化与抑郁的增加相关（r = -0.46，p = 0.008）。疲劳在恶化后 6 周恢复。结论：与年龄匹配的对照受试者相比，COPD 患者的疲劳感增强，并且当患者病情稳定和恶化时，疲劳感与发病率相关。 (C) 2008 ELsevier Ltd. 保留所有权利。
Rationale: The perception of fatigue in COPD has been associated with reduced health status. We have shown that exacerbations are associated with reduced activity and health status. However, the relationship between fatigue and exacerbation is unknown.Objectives: To investigate the hypothesis that increased fatigue is related to physical inactivity and COPD exacerbations.Methods: Fatigue was studied in COPD and age-matched control subjects. The relationship between fatigue and stable patient characteristics in COPD, and the effect of exacerbation on fatigue were evaluated.Measurements: 107 COPD patients mean age 69 years (range 43-86), FEV1 53% (SD 21), and 30 aged-matched control subjects; Functional Assessment of Chronic Illness Therapy-Fatigue Scale, Centre for Epidemiological Studies Depression Scale.Main results: Fatigue in COPI) patients was significantly increased compared to control subjects (mean 35.3 units (SD 11.0) versus 43.2 (10.5), p = 0.001). Increase in fatigue in COPD was related to reduced time spent outdoors (r = -0.43, p < 0.001), increase in depression (r = -0.59, p < 0.001) and annual exacerbation frequency (r = -0.27, p = 0.005). Fatigue increased at exacerbation in 31/32 patients. Overall, fatigue increased by 8.3 units (5.9), p < 0.001. Change in fatigue at exacerbation was rel ated to increase in depression (r = -0.46, p = 0.008). Fatigue recovered at 6 weeks following exacerbation.Conclusions: The perception of fatigue increased in patients with COPD compared to age-matched control subjects, and associated with morbidity when patients were stable and at exacerbation. (C) 2008 ELsevier Ltd. All rights reserved.