【作者】 何鑫；

【导师】 阳惠湘；

【作者基本信息】 中南大学 ， 临床医学（专业学位）， 2022， 硕士

【摘要】 目的:本研究旨在观察IBD患者疲劳现状,分析IBD疲劳的影响因素,评估疲劳对IBD疾病结局的影响,以期帮助临床医师更好地认识IBD患者的疲劳。方法:横断面开放性临床观察2021年1月至2021年12月在中南大学湘雅医院消化内科门诊及住院部就诊的IBD患者,填写自制调查问卷收集患者一般资料、多维疲劳量表评估患者疲劳、睡眠状况自评量表评估患者的睡眠状态,同时收集患者临床资料、实验室检查结果及影像学资料。建立logistics回归模型分析性别、年龄、婚姻、职业、受教育程度、体重指数、吸烟史、睡眠障碍、疾病类型、疾病活动度、病程、治疗药物、手术史、白细胞计数、淋巴细胞计数、贫血、低蛋白血症、高脂血症、CRP、ESR对疲劳的影响;通过Spearman等级相关系数评估疲劳与睡眠障碍及疾病活动度的相关性。结果:本研究共纳入161例IBD患者,包括137例CD患者和24例UC患者。IBD患者疲劳发生率为41.6%,其中疾病活动期及缓解期分别为53.1%及30.0%。疲劳与睡眠障碍呈正相关(r=0.5163;P<0.0001)。多因素logistics回归分析提示疲劳与婚姻状态(OR=2.712;95%CI:1.018-7.224,P=0.046)、SRSS评分(OR=1.152;95%CI:1.074-1.237,P<0.001)和疾病活动度(OR=2.381;95%CI:1.142-4.961,P=0.021)显著相关,而与IBD的类型、年龄、性别、BMI、贫血、低白蛋白血症、高脂血症、CRP、ESR无关。结论:1.疲劳作为一种经常被临床医生忽视的症状,在IBD患者中发生率为41.6%;2.疾病缓解期仍有30%的IBD患者感到疲劳,提示这一部分IBD患者治疗仍未达标;3.疲劳发生率与睡眠障碍、疾病活动度和婚姻状态有关,其中睡眠障碍是疲劳的最强预测指标。图6幅,表11个,参考文献53篇更多还原

【Abstract】 Objective: The study was aimed to determine the prevalence of fatigue in patients with IBD,to identify the factors associated with fatigue,and to evaluate the relationship between fatigue and sleep disorder.In order to help clinicians have better awareness of fatigue.Methods: A cross-sectional study was conducted at Xiangya Hospital of Central South University from February to December 2021.Data were collected by questionnaire survey,including demographic data by self-made questionnaire,fatigue was assessed using the multidimensional fatigue inventory,sleep disorder was assessed by SelfRating Scale of Sleep.Clinical data and laboratory examination results of patients were also collected.Logistic regression analyses were performed to evaluate the association between gender,age,marital status,employment state,education level,BMI,smoking,type of IBD,disease activity,disease duration,hemoglobin,medical therapy,IBD-related surgery,lymphocyte count,anemia,hypoalbuminemia,hyperlipidemia,CRP and ESR with fatigue.Spearman’s rank correlation coefficient was used to evaluate the correlation between fatigue with sleep disorder and disease activity.Results: A total of 161 IBD patients,comprising 137 CD patients and 24 UC patients,were enrolled.The prevalence of fatigue in patients was 41.6%,including 53.1% in patients with active IBD and 30.0% in patients in remission.Marital status(OR=2.712,95%CI: 1.018-7.224,P=0.046),sleep disorder(OR=1.152,95%CI: 1.074-1.237,P < 0.001)and disease activity(OR=2.381,95%CI: 1.142-4.961,P=0.021)were significantly associated with fatigue in IBD patients.There was no significant correlation between the prevalence of fatigue and type of IBD,age,gender,BMI,anemia,hypoalbuminemia,hyperlipidemia,CRP and ESR.In addition,there was a positive correlation between fatigue and sleep disorder(r=0.5163;P<0.0001).Conclusion:1.Fatigue is common in patients with IBD in Central-southern China,even in quiescent IBD patients;2.30% of patients with IBD in remission still have fatigue,suggesting this part of IBD patients didn’t reach the long-term treatment target;3.Fatigue is associated with marital status,sleep disorder and disease activity,and sleep disorder is the strongest predictor of fatigue.更多还原