PDF(Pubmed)
Abstract：
OBJECTIVE: To determine if self-reported fatigue, anxiety, depression, cognitive difficulties, health-related quality of life, disease activity scores and neuropsychological battery (NB) cluster into distinct groups in patients with SLE based on symptom intensity and if they change at 1-year follow-up.
METHODS: This is a retrospective analysis of consecutive consenting patients, followed at a single centre. Patients completed a comprehensive NB, the Beck Anxiety Inventory, Beck Depression Inventory, Fatigue Severity Scale, Short-Form Health Survey Physical Component Summary and Mental Component Summary scores and the Perceived Deficits Questionnaire. Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index 2000. Ward\'s method was used for clustering and principal component analysis was used to visualise the number of clusters. Stability at 1 year was assessed with kappa statistic.
RESULTS: Among 142 patients, three clusters were found: cluster 1 had mild symptom intensity, cluster 2 had moderate symptom intensity and cluster 3 had severe symptom intensity. At 1-year follow-up, 49% of patients remained in their baseline cluster. The mild cluster had the highest stability (77% of patients stayed in the same cluster), followed by the severe cluster (51%), and moderate cluster had the lowest stability (3%). A minority of patients from mild cluster moved to severe cluster (19%). In severe cluster, a larger number moved to moderate cluster (40%) and fewer to mild cluster (9%).
CONCLUSIONS: Three distinct clusters of symptom intensity were documented in patients with SLE in association with cognitive function. There was a lower tendency for patients in the mild and severe clusters to move but not moderate cluster over the course of a year. This may demonstrate an opportunity for intervention to have moderate cluster patients move to mild cluster instead of moving to severe cluster. Further studies are necessary to assess factors that affect movement into moderate cluster.
METHODS: This is a retrospective analysis of consecutive consenting patients, followed at a single centre. Patients completed a comprehensive NB, the Beck Anxiety Inventory, Beck Depression Inventory, Fatigue Severity Scale, Short-Form Health Survey Physical Component Summary and Mental Component Summary scores and the Perceived Deficits Questionnaire. Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index 2000. Ward\'s method was used for clustering and principal component analysis was used to visualise the number of clusters. Stability at 1 year was assessed with kappa statistic.
RESULTS: Among 142 patients, three clusters were found: cluster 1 had mild symptom intensity, cluster 2 had moderate symptom intensity and cluster 3 had severe symptom intensity. At 1-year follow-up, 49% of patients remained in their baseline cluster. The mild cluster had the highest stability (77% of patients stayed in the same cluster), followed by the severe cluster (51%), and moderate cluster had the lowest stability (3%). A minority of patients from mild cluster moved to severe cluster (19%). In severe cluster, a larger number moved to moderate cluster (40%) and fewer to mild cluster (9%).
CONCLUSIONS: Three distinct clusters of symptom intensity were documented in patients with SLE in association with cognitive function. There was a lower tendency for patients in the mild and severe clusters to move but not moderate cluster over the course of a year. This may demonstrate an opportunity for intervention to have moderate cluster patients move to mild cluster instead of moving to severe cluster. Further studies are necessary to assess factors that affect movement into moderate cluster.
摘要：
目的：为了确定自我报告的疲劳，焦虑,抑郁症,认知困难，与健康相关的生活质量，SLE患者的疾病活动评分和神经心理电池(NB)根据症状强度以及在1年随访时是否有变化而分为不同组.
方法：这是一项对连续同意的患者的回顾性分析，在一个单一的中心。患者完成了全面的NB，贝克焦虑量表,贝克抑郁量表，疲劳严重程度量表,简短的健康调查身体成分汇总和心理成分汇总得分和感知缺陷问卷。通过系统性红斑狼疮疾病活动指数2000评估疾病活动。Ward的方法用于聚类，主成分分析用于可视化聚类的数量。用kappa统计量评估1年时的稳定性。
结果：在142例患者中，发现了三个簇：簇1症状强度较轻，第2组症状强度中等,第3组症状强度严重.在1年的随访中，49%的患者保持在他们的基线群。轻度集群具有最高的稳定性（77％的患者留在同一集群中），其次是严重集群(51%)，中度集群的稳定性最低(3%)。少数患者从轻度集群转移到重度集群（19％）。在严重集群中，更多的人转移到中度集群(40%)，更少的人转移到轻度集群(9%)。
结论：在SLE患者中记录了与认知功能相关的三种不同的症状强度。在一年的过程中，轻度和重度集群中的患者移动的趋势较低，但不是中度集群。这可能表明干预有机会使中度集群患者移至轻度集群而不是移至重度集群。需要进一步的研究来评估影响运动到中等集群的因素。
方法：这是一项对连续同意的患者的回顾性分析，在一个单一的中心。患者完成了全面的NB，贝克焦虑量表,贝克抑郁量表，疲劳严重程度量表,简短的健康调查身体成分汇总和心理成分汇总得分和感知缺陷问卷。通过系统性红斑狼疮疾病活动指数2000评估疾病活动。Ward的方法用于聚类，主成分分析用于可视化聚类的数量。用kappa统计量评估1年时的稳定性。
结果：在142例患者中，发现了三个簇：簇1症状强度较轻，第2组症状强度中等,第3组症状强度严重.在1年的随访中，49%的患者保持在他们的基线群。轻度集群具有最高的稳定性（77％的患者留在同一集群中），其次是严重集群(51%)，中度集群的稳定性最低(3%)。少数患者从轻度集群转移到重度集群（19％）。在严重集群中，更多的人转移到中度集群(40%)，更少的人转移到轻度集群(9%)。
结论：在SLE患者中记录了与认知功能相关的三种不同的症状强度。在一年的过程中，轻度和重度集群中的患者移动的趋势较低，但不是中度集群。这可能表明干预有机会使中度集群患者移至轻度集群而不是移至重度集群。需要进一步的研究来评估影响运动到中等集群的因素。
