Analyses of the factors that influence the quality of life of patients with systemic sclerosis / 中华风湿病学杂志

ABSTRACT

Objective To study the factors that may influence the quality of life (QoL) in patients with systemic sclerosis (SSc) by comprehensively evaluating of the patient's condition and to provide evidence for appropriate selection of treatment.Methods Out-patients with SSc in the First Affiliated Hospital of Guangxi Medical University from November 2015 to October 2016 were retrospectively enrolled into this cross-sectional study.Their clinical data were collected.Consecutive SSc patients and 30 healthy controls were recruited and were assessed by the MOS-36 Item Short-Form Health Survey (SF-36),Health Assessment Questionnaire (HAQ),Visual Analogue Scale (VAS) and the St.George's Respiratory Questionaire (SGRQ).The extent of skin involvement of SSc was assessed by the Modified Rodnan skin score (MRSS).The SSc group was divided to diffused SSc (dcSSc) and localized SSc (lcSSc) according's to extent of skin involvement.Pearson's correlation analysis was used to assess the associated clinical indications with the QoL.Results ① Sixty-eight SSc patients were studied [mean age (52±11) years,mean disease duration (35±48) months],in which 59(87％)patients had Raynaud's pheno-menon,9(13％) patients hadfinger ulcer,16(24％) patients were complicated with PAH,and anti-Scl-70 antibody was positive in 59(87％) cases.② The SSc patients had significantly lower SF-36 scale score,including physical function (PF) (64±29),role-physical (RP) (53 ±33),bodily pain (BP)(66±19),social function (SF) (53±20),general health (GH) (58±24),vitality (VT) (53±18),role emotional (RE)(47±35),mental health (MH) (45±21),compared with the healthy-control group (t=7.726,7.132,8.586,12.29,8.296,9.526,6.893,13.973,4.384),all P＜0.01).The SSc patients had significantly higher scale scores of HAQ (t=1 1.823),VAS (t=19.578) and SGRQ (t=14.043,16.688,21.210,20.053),all P＜0.01.③ Compared with lcSSc patients,the SF-36 of dcSSc patient in the PF (F=17.035,P=0.030),RP (F=17.579,P=0.033),BP (F=23.002,P=0.032),VT (F=35.737,P=0.008) were decreased.The HAQ and VAS scale of dcSSc patients were significantly higher than lcSSc patients (F=42.541 and 110.243,P＜0.01).④ The PF,RP,VT,SF,MH of SF-36 scale score in SSc patients was inversely associated with HRCT scores (r=-5.088,-2.896,-2.566,-3.450,-4.173),MRSS (r=-3.847,-3.044,-2.651,-2.571,-2.455),but positively correlated with Complement3 (C3)(r=2.372,2.133,2.370,2.493,2.387).BP,and HAQ scores,VAS were associated with Raynaud's phenomenon (r=2.502,-2.683,-3.703) and MRSS (r=2.141,-2.683,-3.703).And VAS score was correlated with arthralgia (r=-2.943).The symptom score,activity score,influence score of SGRQ were negatively associated with HRCT score (r=4.001,-3.213,2.478),smoking-state (r=-3.040,-2.007,-2.218),all P＜0.05.Conclusion The SSc patients have impaired physical and mental function in the QoL,limited mobility,increased physical pain compared to healthy controls.DcSSc patients have worse QoL index compared with lcSSc patients.For SSc patients with pulmonary fibrosis,extensive skin involvement,high C3 level might have poor QoL.