背景:本研究旨在探讨视神经脊髓炎谱系障碍(NMOSD)患者自主神经失调症状负担的临床危险因素及其对患者生活质量的影响。
方法:共纳入63例NMOSD患者和健康对照。所有参与者都完成了复合自主神经症状评分31(COMPASS-31)以筛查自主神经功能障碍的症状。对NMOSD患者进行了全面的临床评估,如疾病特征和生活状态的综合评估,包括生活质量,焦虑/抑郁,睡眠,和疲劳。分析植物神经失调症状与生活质量的相关因素。
结果:NMOSD组COMPASS-31评分为17.2±10.3,明显高于健康对照组(P=0.002)。在NMOSD患者中,较高的COMPASS-31评分与更多的攻击相关(r=0.49,P<0.001),病程较长(r=0.52,P<0.001),严重残疾(r=0.50,P<0.001),胸髓病变较多(r=0.29,P=0.02),更多的脊髓总病变(r=0.35,P=0.005),严重焦虑(r=0.55,P<0.001),抑郁越严重(r=0.48,P<0.001),严重的睡眠障碍(r=0.59,P<0.001),严重疲劳(r=0.56,P<0.001)。残疾,脊髓总病变,和疲劳是独立的相关因素。进一步分析显示,COMPASS-31得分与患者生活质量量表所有领域的得分独立相关(P<0.05)。
结论:自主神经失调症状负担与生活质量下降和某些临床特征(如残疾)相关。脊髓病变的负担,NMOSD患者的疲劳。自主神经功能障碍的调查和适当管理可能有助于改善NMOSD患者的生活质量。
BACKGROUND: This study aimed to investigate the clinical risk factors of dysautonomic symptom burden in neuromyelitis optica spectrum disorder (NMOSD) and its impact on patients\' quality of life.
METHODS: A total of 63 NMOSD patients and healthy controls were enrolled. All participants completed the Composite Autonomic Symptom Score 31 (COMPASS-31) to screen for symptoms of autonomic dysfunction. A comprehensive clinical evaluation was performed on NMOSD patients, such as disease characteristics and composite evaluations of life status, including quality of life, anxiety/depression, sleep, and fatigue. Correlated factors of dysautonomic symptoms and quality of life were analyzed.
RESULTS: The score of COMPASS-31 in the NMOSD group was 17.2 ± 10.3, significantly higher than that in healthy controls (P = 0.002). In NMOSD patients, the higher COMPASS-31 score was correlated with more attacks (r = 0.49, P < 0.001), longer disease duration (r = 0.52, P < 0.001), severer disability (r = 0.50, P < 0.001), more thoracic cord lesions (r = 0.29, P = 0.02), more total spinal cord lesions (r = 0.35, P = 0.005), severer anxiety (r = 0.55, P < 0.001), severer depression (r = 0.48, P < 0.001), severer sleep disturbances (r = 0.59, P < 0.001), and severer fatigue (r = 0.56, P < 0.001). The disability, total spinal cord lesions, and fatigue were revealed to be independently associated factors. Further analysis revealed that the COMPASS-31 score was independently correlated with scores of all the domains of patients\' quality of life scale (P < 0.05).
CONCLUSIONS: Dysautonomic symptom burden is correlated with decreased quality of life and certain clinical characteristics such as disability, the burden of spinal cord lesions, and fatigue in NMOSD patients. Investigation and proper management of autonomic dysfunction may help to improve the quality of life in patients with NMOSD.