Valencia-Flores M, Cardiel M H, Santiago V, Resendiz M, Castaño V A, Negrete O, Rosenberg C, García-Ramos G, Alcocer J, Alarcón-Segovia D
Departamento de Neurologia y Psiquiatra, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Delegación Tlalpan, México 14000, DF, México.
Lupus. 2004;13(1):4-10. doi: 10.1191/0961203304lu480oa.
In total, 189 consecutive women diagnosed with SLE were evaluated using the ACR 1990 criteria for fibromyalgia. Patients were classified into three subgroups. The fibromyalgia group (FM) included patients experiencing pain on palpation in at least 11 of the 18 tender points examined, as well as having a history of widespread pain for at least three months. Patients who were noted to have pain in fewer than four quadrants with less than 11 of 18 tender points were considered to have regional pain (RP). All patients who did not meet criteria for either FM or RP were classified as having no pain (NP). Measurement of SLE disease activity, sleep complaints, depression, fatigue severity and health status were performed. Only 18 of the SLE patients (9.5%) (95% CI 5.3-14%) fulfilled the ACR criteria for the classification of FM. Of the patients, 106 (56.1%) fulfilled criteria for RP and had a number of tender points of 5.4 +/- 3.4, and the rest of the patients (34.4%) had no tenderness at specific tender point sites. Age, body mass index, educational level and disease duration were comparable between the groups. FM and RP groups had different patterns of symptoms prevalence, with dysmenorrhea being more distinctive for FM. Sleep disturbances were more severe in the FM than in the RP group. Daytime complaints such as sleepiness, fatigue and depression were similar for RP and FM groups, but patients with FM reported more disability. Fibromyalgia is not common in Mexican patients with SLE and has a different pattern of symptoms in RP and NP patients. These data add evidence that ethnicity can play an important role in FM manifestations.
总共，对189例连续诊断为系统性红斑狼疮（SLE）的女性患者，使用美国风湿病学会（ACR）1990年纤维肌痛标准进行评估。患者被分为三个亚组。纤维肌痛组（FM）包括在检查的18个压痛点中至少有11个存在触痛，且有至少三个月广泛性疼痛病史的患者。在少于四个象限有疼痛且18个压痛点中少于11个有压痛的患者被认为有局部疼痛（RP）。所有不符合FM或RP标准的患者被分类为无疼痛（NP）。进行了SLE疾病活动度、睡眠主诉、抑郁、疲劳严重程度和健康状况的测量。只有18例SLE患者（9.5%）（95%可信区间5.3 - 14%）符合ACR纤维肌痛分类标准。在这些患者中，106例（56.1%）符合RP标准，压痛点数量为5.4±3.4，其余患者（34.4%）在特定压痛点部位无压痛。各组之间年龄、体重指数、教育水平和病程具有可比性。FM组和RP组有不同的症状患病率模式，痛经在FM组更为突出。FM组的睡眠障碍比RP组更严重。RP组和FM组白天的主诉如嗜睡、疲劳和抑郁相似，但FM组患者报告的残疾更多。纤维肌痛在墨西哥SLE患者中并不常见，且在RP组和NP组有不同的症状模式。这些数据进一步证明种族在纤维肌痛表现中可发挥重要作用。
