Solomon Laura, Reeves William C
Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Arch Intern Med. 2004 Nov 8;164(20):2241-5. doi: 10.1001/archinte.164.20.2241.
Most of what is believed about chronic fatigue syndrome (CFS) is based on clinic-based studies. These studies may not reflect CFS cases in the population.
We used data from a population-based study of CFS to identify factors associated with receiving a CFS diagnosis. Wichita, Kan, residents were screened by random-digit dialing. Eligible individuals completed a telephone interview. Respondents meeting CFS criteria were invited for a clinical evaluation to confirm CFS. We analyzed all persons with confirmed CFS. The main outcomes of this study, prevalence and incidence of CFS, are published elsewhere. Herein, we present an exploratory analysis with previous CFS diagnosis as the outcome, predicted by demographic and symptom characteristics.
We confirmed CFS in 90 subjects; 14 (16%) had been previously diagnosed as having CFS. Persons in the middle- vs the higher-income group were more likely to have been diagnosed as having CFS (9 [29%] of 31 subjects vs 3 [8%] of 39 subjects; P = .03), as were those with sudden vs gradual fatigue onset (7 [41%] of 17 subjects vs 4 [6%] of 64 subjects; P < .01), those reporting tender lymph nodes (7 [33%] of 21 subjects vs 7 [10%] of 69 subjects; P = .02), and those reporting a sore throat (6 [35%] of 17 subjects vs 8 [11%] of 73 subjects; P = .02). Only 17 (21%) of 81 subjects had sudden fatigue onset, and tender lymph nodes (reported in 21 [23%] of 90 subjects) and a sore throat (reported in 17 [19%] of 90 subjects) were the least common symptoms.
Most cases of CFS in the population are unrecognized by the medical community; persons diagnosed as having CFS may be different from persons with CFS in the general population.
目前关于慢性疲劳综合征（CFS）的大多数认知都基于临床研究。这些研究可能无法反映普通人群中的CFS病例。
我们使用了一项基于人群的CFS研究数据，以确定与获得CFS诊断相关的因素。堪萨斯州威奇托市的居民通过随机数字拨号进行筛查。符合条件的个体完成电话访谈。符合CFS标准的受访者被邀请进行临床评估以确诊CFS。我们分析了所有确诊为CFS的人。本研究的主要结果，即CFS的患病率和发病率，已在其他地方发表。在此，我们以先前的CFS诊断为结果进行探索性分析，以人口统计学和症状特征作为预测因素。
我们确诊了90例CFS患者；其中14例（16%）之前被诊断为患有CFS。中等收入组与高收入组相比，前者被诊断为患有CFS的可能性更高（31名受试者中有9例[29%]，39名受试者中有3例[8%]；P = 0.03），突发疲劳与渐进性疲劳发作的患者也是如此（17名受试者中有7例[41%]，64名受试者中有4例[6%]；P < 0.01），报告有触痛淋巴结的患者（21名受试者中有7例[33%]，69名受试者中有7例[10%]；P = 0.02），以及报告有喉咙痛的患者（17名受试者中有6例[35%]，73名受试者中有8例[11%]；P = 0.02）。81名受试者中只有17例（21%）有突发疲劳发作，触痛淋巴结（90名受试者中有21例[23%]报告有此症状）和喉咙痛（90名受试者中有17例[19%]报告有此症状）是最不常见的症状。
普通人群中的大多数CFS病例未被医学界识别；被诊断为患有CFS的人与普通人群中的CFS患者可能有所不同。
