Jones Gareth T, Silman Alan J, Macfarlane Gary J
Unit of Chronic Disease Epidemiology, and Arthritis Research Campaign Epidemiology Unit, University of Manchester, Manchester, UK.
Arthritis Rheum. 2003 Sep;48(9):2615-21. doi: 10.1002/art.11221.
To determine factors associated with, and the predictors of, widespread body pain in children.
A population-based prospective study was conducted among school children in Northwest England. At baseline, subjects completed a self-report questionnaire on widespread body pain. Information was collected on behavioral and emotional factors, other somatic symptoms, and measures of physical activity/inactivity. Children who were free of widespread pain were contacted again 12 months later to determine any new onset of widespread pain. Regression analyses were used to identify the factors that were associated with the reporting of widespread pain at baseline, and to determine the factors that predicted the new onset of symptoms at followup among those children free of widespread pain at baseline. Results were expressed as relative risks (RR) with 95% confidence intervals (95% CI).
A total of 1,440 children (96%) agreed to participate in the survey at baseline, and of those eligible, 1,081 (88%) participated at followup. The reporting of widespread pain (prevalence 14.6%) and its new onset at the 12-month followup (prevalence 7.7%) was common. At baseline, symptoms were associated with adverse behavioral and emotional factors (RR 2.5, 95% CI 1.8-3.6), with the report of other common childhood somatic symptoms (e.g., frequent headache; RR 3.5, 95% CI 2.2-5.5), and with high levels of sports activity (RR 1.9, 95% CI 1.3-2.9). Furthermore, all of these factors (in the absence of widespread pain at baseline) increased the likelihood of symptom onset at followup.
Children who report behavioral problems or other somatic symptoms are at increased risk, at least in the short term, of developing chronic widespread pain. It remains to be determined whether these are long-term risk factors for the onset of such symptoms, and whether they could be predictors of the development of other functional syndromes.
确定与儿童全身广泛性疼痛相关的因素及其预测指标。
在英格兰西北部的在校儿童中开展了一项基于人群的前瞻性研究。在基线时，受试者完成一份关于全身广泛性疼痛的自我报告问卷。收集了行为和情绪因素、其他躯体症状以及身体活动/不活动指标等信息。12个月后再次联系无全身广泛性疼痛的儿童，以确定是否有任何新出现的全身广泛性疼痛。采用回归分析来确定与基线时全身广泛性疼痛报告相关的因素，并确定在基线时无全身广泛性疼痛的儿童中预测随访时症状新发的因素。结果以相对风险（RR）及95%置信区间（95%CI）表示。
共有1440名儿童（96%）在基线时同意参与调查，其中符合条件的1081名儿童（88%）参与了随访。全身广泛性疼痛的报告（患病率14.6%）及其在12个月随访时的新发情况（患病率7.7%）很常见。在基线时，症状与不良行为和情绪因素相关（RR 2.5，95%CI 1.8 - 3.6），与其他常见儿童躯体症状的报告相关（如频繁头痛；RR 3.5，95%CI 2.2 - 5.5），还与高水平体育活动相关（RR 1.9，95%CI 1.3 - 2.9）。此外，所有这些因素（在基线时无全身广泛性疼痛的情况下）均增加了随访时症状发作的可能性。
报告有行为问题或其他躯体症状的儿童，至少在短期内，发生慢性全身广泛性疼痛的风险增加。这些因素是否为此类症状发作的长期风险因素，以及它们是否可作为其他功能性综合征发展的预测指标，仍有待确定。
