Eisen Seth A, Kang Han K, Murphy Frances M, Blanchard Melvin S, Reda Domenic J, Henderson William G, Toomey Rosemary, Jackson Leila W, Alpern Renee, Parks Becky J, Klimas Nancy, Hall Coleen, Pak Hon S, Hunter Joyce, Karlinsky Joel, Battistone Michael J, Lyons Michael J
Veterans Affairs Medical Center, Washington University School of Medicine, St. Louis, Missouri 63106, USA.
Ann Intern Med. 2005 Jun 7;142(11):881-90. doi: 10.7326/0003-4819-142-11-200506070-00005.
United States military personnel reported various symptoms after deployment to the Persian Gulf during the 1991 Gulf War. However, the symptoms' long-term prevalence and association with deployment remain controversial.
To assess and compare the prevalence of selected medical conditions in a national cohort of deployed and nondeployed Gulf War veterans who were evaluated by direct medical and teledermatologic examinations.
A cross-sectional prevalence study performed 10 years after the 1991 Gulf War.
Veterans were examined at 1 of 16 Veterans Affairs medical centers.
Deployed (n = 1061) and nondeployed (n = 1128) veterans of the 1991 Gulf War.
Primary outcome measures included fibromyalgia, the chronic fatigue syndrome, dermatologic conditions, dyspepsia, physical health-related quality of life (Short Form-36 [SF-36]), hypertension, obstructive lung disease, arthralgias, and peripheral neuropathy.
Of 12 conditions, only 4 conditions were more prevalent among deployed than nondeployed veterans: fibromyalgia (deployed, 2.0%; nondeployed, 1.2%; odds ratio, 2.32 [95% CI, 1.02 to 5.27]); the chronic fatigue syndrome (deployed, 1.6%; nondeployed 0.1%; odds ratio, 40.6 [CI, 10.2 to 161]); dermatologic conditions (deployed, 34.6%; nondeployed, 26.8%; odds ratio, 1.38 [CI, 1.06 to 1.80]), and dyspepsia (deployed, 9.1%; nondeployed, 6.0%; odds ratio, 1.87 [CI, 1.16 to 2.99]). The mean physical component summary score of the SF-36 for deployed and nondeployed veterans was 49.3 and 50.8, respectively.
Relatively low participation rates introduce potential participation bias, and deployment-related illnesses that resolved before the research examination could not, by design, be detected.
Ten years after the Gulf War, the physical health of deployed and nondeployed veterans is similar. However, Gulf War deployment is associated with an increased risk for fibromyalgia, the chronic fatigue syndrome, skin conditions, dyspepsia, and a clinically insignificant decrease in the SF-36 physical component score.
1991年海湾战争期间,美国军事人员在被部署到波斯湾地区后报告出现了各种症状。然而,这些症状的长期流行情况以及与部署之间的关联仍存在争议。
评估并比较一组经直接医学检查和远程皮肤病学检查的已部署和未部署海湾战争退伍军人中特定疾病的患病率。
一项在1991年海湾战争结束10年后进行的横断面患病率研究。
退伍军人在16个退伍军人事务医疗中心之一接受检查。
1991年海湾战争的已部署退伍军人(n = 1061)和未部署退伍军人(n = 1128)。
主要结局指标包括纤维肌痛、慢性疲劳综合征、皮肤病、消化不良、与身体健康相关的生活质量(简短健康调查问卷-36 [SF-36])、高血压、阻塞性肺病、关节痛和周围神经病变。
在12种疾病中,只有4种疾病在已部署退伍军人中的患病率高于未部署退伍军人:纤维肌痛(已部署,2.0%;未部署,1.2%;优势比,2.32 [95% CI,1.02至5.27]);慢性疲劳综合征(已部署,1.6%;未部署,0.1%;优势比,40.6 [CI,10.2至161]);皮肤病(已部署,34.6%;未部署,26.8%;优势比,1.38 [CI,1.06至1.80]),以及消化不良(已部署,9.1%;未部署,6.0%;优势比,1.87 [CI,1.16至2.99])。已部署和未部署退伍军人的SF-36身体成分总结平均得分分别为49.3和50.8。
相对较低的参与率可能会导致潜在的参与偏倚,并且按照设计无法检测到在研究检查之前已缓解的与部署相关的疾病。
海湾战争结束10年后,已部署和未部署退伍军人的身体健康状况相似。然而,海湾战争部署与纤维肌痛、慢性疲劳综合征、皮肤疾病、消化不良的风险增加以及SF-36身体成分得分在临床上无显著意义的降低有关。