Analysis of the clinical characteristics and influencing factors of fatigue symptoms in patients with interstitial lung disease

doi:10.11958/20230264

Abstract

Abstract:

Objective To explore the clinical characteristics and influencing factors of fatigue symptoms in patients with interstitial lung disease (ILD). Methods A total of 238 patients with ILD were selected. Gender, age, marital status, body mass index (BMI), occupation, education, smoking and alcohol consumption of patients were collected. The pulmonary function of patients was measured. The percentage of forced vital capacity in the predicted value (FVC%pred), the percentage of forced expiratory volume in the first second in the predicted value (FEV1%pred), the percentage of forced expiratory volume in the end of the first second in the predicted value (FEV1/FVCpred) and the percentage of diffusing capacity of the lungs for carbon monoxide in the predicted value (DLCO%pred) were detected. The fatigue rating scale (FAS) was used to evaluate the physical and mental fatigue of patients. The improved Medical Research Council Respiratory Questionnaire (mMRC) was used to assess the degree of dyspnea. Charlson comorbidity index was used to evaluate the severity of comorbidity. The hospital anxiety and depression scale (HADS) including HADS-A and HADS-D were used to score the anxiety and depression of patients. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of patients. The differences of FAS scores and the correlation between FAS scores and clinical features were analyzed. Multiple linear stepwise regression analysis was used to explore the influencing factors of fatigue in ILD patients. Results The FAS score of 238 patients was (26.03 ± 9.53), of which 159 (66.81%) experienced fatigue and 60 (37.74%) experienced severe fatigue. The FAS scores of mMRC grade 0 and 1 ILD patients were lower than those of mMRC grade 2, 3 and 4 patients, and the FAS scores of mMRC grade 2 ILD patients were lower than those of mMRC grade 4 patients (P<0.01). There were no significant differences in FAS scores between patients with different course of disease, age, sex, marriage, work, education level, smoking, drinking, ILD type and Charlson complication index. FAS score was positively correlated with age, disease course, HADS-A, HADS-D and PSQI, and negatively correlated with DLCO% pred (P<0.05). Multiple linear stepwise regression analysis showed that HADS-D, mMRC, PSQI and disease course were influencing factors of FAS score (P<0.05). Conclusion The incidence of fatigue is high in ILD patients, and the long course of disease, dyspnea, depression and sleep disorders are important influencing factors of fatigue.

Key words: lung diseases, interstitial, fatigue, dyspnea, depression, sleep disorders, fatigue assessment scale

CLC Number:

R563.9

Figures/Tables 2

References 29

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变量		n	FAS得分	t或F
病程	≥60个月	128	27.02±9.60	1.735
病程	<60个月	110	24.88±9.36	1.735
年龄	<60岁	71	24.83±8.33	1.367
	≥60岁	167	26.54±9.98	1.367
性别	男	109	25.38±9.89	0.978
性别	女	129	26.59±9.22	0.978
婚姻情况	已婚	211	25.65±9.58	1.746
婚姻情况	丧偶/离异	27	29.04±8.73	1.746
工作情况	体力劳动	77	26.51±9.73	0.528
工作情况	非体力劳动	161	25.81±9.46	0.528
教育程度	小学及以下	26	29.69±10.15	2.090
	初中	73	25.59±10.13
	高中	77	26.57±9.66
	本科及以上	62	24.35±8.02
吸烟	从不	164	25.98±9.45	0.008
	已戒	60	26.15±9.77
	正在	14	26.14±10.17
饮酒	从不	183	26.23±9.55	0.597
	已戒	47	25.85±9.57
	正在	8	22.50±9.50
ILD类型	IPF	65	25.57±10.43	0.079
	CTD-ILD	76	26.04±8.22
	IIP	46	26.15±9.38
	其他	51	26.51±10.51
Charlson合并症指数	轻度	191	25.54±9.09	0.936
	中度	43	28.19±11.43
	重度	4	26.25±6.34
mMRC分级	0级	51	19.04±6.09	33.890^＊＊
	1级	74	22.43±7.84
	2级	56	28.89±7.83^ab
	3级	32	32.31±8.74^ab
	4级	25	36.52±7.98^abc

变量		n	FAS得分	t或F
病程	≥60个月	128	27.02±9.60	1.735
病程	<60个月	110	24.88±9.36	1.735
年龄	<60岁	71	24.83±8.33	1.367
	≥60岁	167	26.54±9.98	1.367
性别	男	109	25.38±9.89	0.978
性别	女	129	26.59±9.22	0.978
婚姻情况	已婚	211	25.65±9.58	1.746
婚姻情况	丧偶/离异	27	29.04±8.73	1.746
工作情况	体力劳动	77	26.51±9.73	0.528
工作情况	非体力劳动	161	25.81±9.46	0.528
教育程度	小学及以下	26	29.69±10.15	2.090
	初中	73	25.59±10.13
	高中	77	26.57±9.66
	本科及以上	62	24.35±8.02
吸烟	从不	164	25.98±9.45	0.008
	已戒	60	26.15±9.77
	正在	14	26.14±10.17
饮酒	从不	183	26.23±9.55	0.597
	已戒	47	25.85±9.57
	正在	8	22.50±9.50
ILD类型	IPF	65	25.57±10.43	0.079
	CTD-ILD	76	26.04±8.22
	IIP	46	26.15±9.38
	其他	51	26.51±10.51
Charlson合并症指数	轻度	191	25.54±9.09	0.936
	中度	43	28.19±11.43
	重度	4	26.25±6.34
mMRC分级	0级	51	19.04±6.09	33.890^＊＊
	1级	74	22.43±7.84
	2级	56	28.89±7.83^ab
	3级	32	32.31±8.74^ab
	4级	25	36.52±7.98^abc

变量	β	SE	标准化β	t	P
HADS-D	0.730	0.099	0.364	7.359	<0.001
mMRC分级	2.830	0.347	0.372	8.147	<0.001
PSQI	0.495	0.098	0.248	5.054	<0.001
病程	0.139	0.070	0.084	1.993	0.047
常数项	11.797	0.963		12.247	<0.001

变量	β	SE	标准化β	t	P
HADS-D	0.730	0.099	0.364	7.359	<0.001
mMRC分级	2.830	0.347	0.372	8.147	<0.001
PSQI	0.495	0.098	0.248	5.054	<0.001
病程	0.139	0.070	0.084	1.993	0.047
常数项	11.797	0.963		12.247	<0.001