Women's College Hospital, Family and Community Medicine, Toronto, ON M5S 1B2.
Can Fam Physician. 2010 Feb;56(2):e57-65.
To characterize patients diagnosed with multiple chemical sensitivity (MCS), chronic fatigue syndrome (CFS), or fibromyalgia (FM), to compare their level of function with Canadian population average values, and to assess factors associated with function.
Chart review and abstraction of clinical information.
The Environmental Health Clinic (EHC) at Women's College Hospital in Toronto, Ont, which is a provincial referral centre for patients with illnesses with suspected environmental links, especially MCS, CFS, and FM.
A total of 128 consecutive patients diagnosed with 1 or more of MCS, CFS, or FM, seen between January 2005 and March 2006 at the EHC.
Demographic and socioeconomic characteristics, comorbid diagnoses, duration of illness, health services usage, life stresses, helpful therapeutic strategies, and functional impairment measured by the Short Form-36, compared with Canadian population average values. Factors significantly associated with function in bivariate analyses were included in multiple linear and logistic regression models.
The patient population was predominantly female (86.7%), with a mean age of 44.6 years. Seventy-eight patients had discrete diagnoses of 1 of MCS, CFS, or FM, while the remainder had 2 or 3 overlapping diagnoses. Most (68.8%) had stopped work, and on average this had occurred 3 years after symptom onset. On every Short Form-36 subscale, patients had markedly lower functional scores than population average values, more so when they had 2 or 3 of these diagnoses. Having FM, younger age at onset, and lower socioeconomic status were most consistently associated with poor function.
Patients seen at the EHC demonstrated marked functional impairment, consistent with their reported difficulties working and caring for their homes and families during what should be their peak productive years. Early comprehensive assessment, medical management, and social and financial support might avoid the deterioration of function associated with prolonged illness. Education and information resources are required for health care professionals and the public, along with further etiologic and prognostic research.
对被诊断为多发性化学敏感性（MCS）、慢性疲劳综合征（CFS）或纤维肌痛（FM）的患者进行特征描述，将其功能水平与加拿大人群的平均数值进行比较，并评估与功能相关的因素。
病历回顾和临床信息提取。
安大略省多伦多市女子学院医院的环境健康诊所（EHC），该诊所是有疑似环境关联疾病，尤其是 MCS、CFS 和 FM 的患者的省级转诊中心。
2005 年 1 月至 2006 年 3 月期间在 EHC 就诊的 128 例连续诊断为 1 种或多种 MCS、CFS 或 FM 的患者。
人口统计学和社会经济学特征、合并诊断、疾病持续时间、卫生服务使用、生活压力、有帮助的治疗策略以及使用 36 项简短健康调查量表（Short Form-36）测量的功能障碍，与加拿大人群的平均数值进行比较。在单变量分析中与功能显著相关的因素被纳入多元线性和逻辑回归模型。
患者人群主要为女性（86.7%），平均年龄为 44.6 岁。78 例患者被明确诊断为 1 种 MCS、CFS 或 FM，其余患者则有 2 种或 3 种重叠诊断。大多数患者（68.8%）已经停止工作，平均在症状出现 3 年后出现这种情况。在 36 项简短健康调查量表的每一个子量表中，患者的功能评分都明显低于人群的平均数值，当他们有 2 种或 3 种这些诊断时，情况更为严重。患有 FM、发病年龄较小以及社会经济地位较低与功能较差最密切相关。
在 EHC 就诊的患者表现出明显的功能障碍，这与其在本应是生产力最高的年龄段报告的工作和照顾家庭的困难一致。早期全面评估、医疗管理以及社会和经济支持可能会避免与疾病长期存在相关的功能恶化。需要为卫生保健专业人员和公众提供教育和信息资源，同时还需要进行进一步的病因学和预后研究。
