Reeves William C, Wagner Dieter, Nisenbaum Rosane, Jones James F, Gurbaxani Brian, Solomon Laura, Papanicolaou Dimitris A, Unger Elizabeth R, Vernon Suzanne D, Heim Christine
Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
BMC Med. 2005 Dec 15;3:19. doi: 10.1186/1741-7015-3-19.
The lack of standardized criteria for defining chronic fatigue syndrome (CFS) has constrained research. The objective of this study was to apply the 1994 CFS criteria by standardized reproducible criteria.
This population-based case control study enrolled 227 adults identified from the population of Wichita with: (1) CFS (n = 58); (2) non-fatigued controls matched to CFS on sex, race, age and body mass index (n = 55); (3) persons with medically unexplained fatigue not CFS, which we term ISF (n = 59); (4) CFS accompanied by melancholic depression (n = 27); and (5) ISF plus melancholic depression (n = 28). Participants were admitted to a hospital for two days and underwent medical history and physical examination, the Diagnostic Interview Schedule, and laboratory testing to identify medical and psychiatric conditions exclusionary for CFS. Illness classification at the time of the clinical study utilized two algorithms: (1) the same criteria as in the surveillance study; (2) a standardized clinically empirical algorithm based on quantitative assessment of the major domains of CFS (impairment, fatigue, and accompanying symptoms).
One hundred and sixty-four participants had no exclusionary conditions at the time of this study. Clinically empirical classification identified 43 subjects as CFS, 57 as ISF, and 64 as not ill. There was minimal association between the empirical classification and classification by the surveillance criteria. Subjects empirically classified as CFS had significantly worse impairment (evaluated by the SF-36), more severe fatigue (documented by the multidimensional fatigue inventory), more frequent and severe accompanying symptoms than those with ISF, who in turn had significantly worse scores than the not ill; this was not true for classification by the surveillance algorithm.
The empirical definition includes all aspects of CFS specified in the 1994 case definition and identifies persons with CFS in a precise manner that can be readily reproduced by both investigators and clinicians.
缺乏定义慢性疲劳综合征（CFS）的标准化标准限制了研究。本研究的目的是通过标准化的可重复标准应用1994年CFS标准。
这项基于人群的病例对照研究纳入了从威奇托人群中识别出的227名成年人，他们分别为：（1）CFS患者（n = 58）；（2）在性别、种族、年龄和体重指数方面与CFS匹配的非疲劳对照者（n = 55）；（3）患有医学上无法解释的疲劳但非CFS的人，我们称之为ISF（n = 59）；（4）伴有抑郁性抑郁症的CFS患者（n = 27）；以及（5）ISF加抑郁性抑郁症患者（n = 28）。参与者入院两天，接受病史和体格检查、诊断性访谈表以及实验室检测，以确定排除CFS的医学和精神疾病状况。临床研究时的疾病分类采用两种算法：（1）与监测研究相同的标准；（2）基于对CFS主要领域（损伤、疲劳及伴随症状）进行定量评估的标准化临床经验算法。
164名参与者在本研究时没有排除性疾病状况。临床经验分类将43名受试者鉴定为CFS，57名鉴定为ISF，64名鉴定为未患病。经验分类与监测标准分类之间的关联极小。经验分类为CFS的受试者比ISF受试者有更严重的损伤（通过SF - 36评估）、更严重的疲劳（由多维疲劳量表记录）、更频繁和严重的伴随症状，而ISF受试者又比未患病者得分显著更差；监测算法分类则并非如此。
经验性定义涵盖了19
