摘要
目的:探索超重和肥胖对中国纤维肌痛综合征(fibromyalgia syndrome,FMS)患者的症状严重程度和生活质量的影响.方法:采用横断面调查的研究方法采集2018年10月至2021年12月就诊于广安门医院风湿病科门诊435例FMS患者的身高、体重、性别和年龄等一般资料,压痛点个数、普遍疼痛指数及症状严重性量表数据作为疾病诊断指标,疼痛视觉模拟评分、贝克(Beck)抑郁量表、压力感知量表(perceived stress scale,PSS)、匹兹堡睡眠质量指数(Pittsburg sleep quality index,PSQI)及多维疲劳量表用于评估疾病疼痛、负性情绪、压力感知、睡眠质量,以及疲劳症状的严重程度,采用修订版纤维肌痛影响问卷、纤维肌痛症状量表(fibromyalgia severity,FS),以及生活质量评价量表(36 item short-form health survey,SF-36)评价FMS患者的整体病情及生活质量.同时招募50例性别和年龄匹配的健康志愿者作为对照组,并采用协方差分析的方法在校正年龄和性别的基础上探索超重和肥胖对FMS患者的影响.结果:采用中国体重指数(body mass index,BMI)标准,正常体重组与超重和肥胖组FMS患者分别有242 例(59％)和 170 例(41％),平均 BMI 分别为(21.66±1.42)kg/m2 和(26.25±1.83)kg/m2.与正常体重FMS患者相比,超重和肥胖患者的PSS评分(P=0.010)、PSQI子维度睡眠效率评分(P＜0.001)及FS评分(P=0.025)均更高,SF-36量表子维度的生理机能评分(P=0.041)更低;而健康对照组正常体重者与超重和肥胖者以上指标相比差异均无统计学意义(P＞0.05).结论:相较于正常体重FMS患者,超重和肥胖患者压力感知水平更高、睡眠效率更低、纤维肌痛症状严重程度更高,同时表现为以生理机能下降为主的低水平生活质量.由此可见,FMS患者积极控制体重将有助于改善睡眠效率和心理状态,提高生理机能,并减轻整体病情.
Abstract
Objective:To explore the effects of overweight and obesity(overweight/obesity)on symp-tom severity and quality of life in Chinese patients with fibromyalgia syndrome(FMS).Methods:A cross-sectional survey was used to collect general data on height,weight,gender and age of 435 FMS pa-tients who visited the rheumatology clinic of Guang'anmen Hospital from October 2018 to December 2021.The numbers of tender points,widespread pain index and symptom severity scale were used as diagnostic indicators of the disease.The pain visual analogue scale,Beck depression inventory,perceived stress scale(PSS),Pittsburgh sleep quality index(PSQI)and multidimensional fatigue scale were used to as-sess the severity of pain and negative emotions,stress perception,sleep quality,and fatigue symptoms of this disease.The revised fibromyalgia impact questionnaire,fibromyalgia symptom scale(FS)and quali-ty of life assessment scale(36 item short-form health survey,SF-36)were used to evaluate the overall condition and quality of life of the FMS patients.At the same time,50 healthy volunteers matched in gender and age were recruited as the control group.Covariance analysis was used to explore the effects of overweight/obesity on the FMS patients after adjusting for age and gender.Results:According to the Chinese body mass index(BMI)standard,there were 242(59％)and 170(41％)FMS patients in the normal weight group and overweight/obesity group,respectively,with average BMI of(21.66±1.42)kg/m2 and(26.25±1.83)kg/m2,respectively.Compared with the normal weight FMS patients,the overweight/obesity patients had higher PSS scores(P=0.010),PSQI sub-dimension sleep efficiency scores(P＜0.001)and FS scores(P=0.025),and lower SF-36 sub-dimension physical functioning scores(P=0.041).However,there were no statistical differences in the above indicators between nor-mal weight and overweight/obesity patients in the healthy control group(P＞0.05).Conclusion:Com-pared with normal-weight FMS patients,overweight/obesity patients have higher levels of perceived stress,lower sleep efficiency,and more severe fibromyalgia symptoms,as well as a low quality of life characterized by decreased physiological function.It is important for overweight/obesity FMS patients to control BMI actively in order to improve sleep efficiency,psychological state,physical functioning,and the overall condition.
万方数据