Pongratz D E, Sievers M
Friedrich-Baur-Institut, University of Munich, München, Germany.
Scand J Rheumatol Suppl. 2000;113:3-7. doi: 10.1080/030097400446553.
According to the American College of Rheumatology the diagnosis of fibromyalgia is based on criteria for the classification of fibromyalgia consisting entirely of clinical signs and symptoms. For diagnostic reasons autonomic disturbances and mental features have to be considered. The distinction between fibromyalgia (tender points) and myofascial pain syndrome (trigger points) is essential. Internal and neurological disorders as a primary cause of fibromyalgia have to be excluded. The etiology and pathogenesis of fibromyalgia still remain uncertain. The myopathological patterns in fibromyalgia are non-specific: type II fiber atrophy, an increase of lipid droplets, a slight proliferation of mitochondria, and a slightly elevated incidence of ragged red fibers. Initial reports on some allelic abnormalities in the serotonin system seem to highlight the important role of serotonin already presumed earlier. Significantly high levels of substance P in the cerebrospinal fluid of FM patients additionally support the impact of these neurotransmitters on both nociceptive and antinociceptive mechanisms.
根据美国风湿病学会的说法，纤维肌痛的诊断基于纤维肌痛分类标准，该标准完全由临床体征和症状组成。出于诊断原因，必须考虑自主神经紊乱和精神特征。区分纤维肌痛（压痛点）和肌筋膜疼痛综合征（触发点）至关重要。必须排除作为纤维肌痛主要病因的内科和神经疾病。纤维肌痛的病因和发病机制仍不确定。纤维肌痛的肌病理模式是非特异性的：II型纤维萎缩、脂滴增加、线粒体轻度增生以及破碎红纤维的发生率略有升高。关于血清素系统中一些等位基因异常的初步报告似乎凸显了血清素早已被推测的重要作用。纤维肌痛患者脑脊液中P物质水平显著升高，进一步支持了这些神经递质对伤害性感受和抗伤害性感受机制的影响。
