Department of Internal Medicine, Division of Rheumatology, University of Pisa, Italy.
Clin Exp Rheumatol. 2010 Nov-Dec;28(6 Suppl 63):S94-9. Epub 2010 Dec 22.
To evaluate the role of spasmophilia (SP) in fibromyalgia syndrome (FM).
Three hundred and fourteen patients (280 F, 34 M) with a diagnosis of FM or FM and spasmophilia (FM+SP) were recruited. Clinical assessment of patients and controls included the Questionnaires FIQ, HAQ and the tender point (TP) count. Life-time or ongoing psychiatric aspects were evaluated by trained psychiatrists by means of the classic scales: Structured Clinical Interview (SCID) for DSM-IV. The following analysis were evaluated: cytokine (IL1, IL2, IL6, IL8, IL10), TNF-α, cortisol, GH, ACTH, IGF1, 5HT, intracellular Mg, plasma calcium p(Ca), PTH, (25(OH)D) and thyroid functionality. Some typical symptoms were investigated.
Eighty-one patients resulted positive for spamophilia (FM+SP), while 233 resulted negative for spasmophilia (FM). The mean TP number resulted higher in the FM group (15.33±3.88) with respect to FM+SP (12.88±6.17, p=0.016), while FIQ and HAQ did not differ between the two studied groups. FM patients exhibited a higher frequency of psychiatric disorders with respect to FM+SP patients (72% FM vs. 49% FM+SP, p<0.01). In particular the frequency of depression was 65.5% FM vs. 35% FM+SP (p<0.01).
The presence of spasmophilia seems to influence psychiatric comorbidity which was less prevalent in FM+SP patients. FM is indeed characterised by an abnormal sensory processing of pain that seems to result from a combination of interactions between neurotransmitters, stress, hormones and the nervous system; spasmophilia would seem to be more linked to a dysfunction at the neuromuscular level.
评估痉挛性疾病（SP）在纤维肌痛综合征（FM）中的作用。
共招募了 314 名患者（280 名女性，34 名男性），这些患者被诊断为 FM 或 FM 伴痉挛性疾病（FM+SP）。通过训练有素的精神科医生使用经典量表，对患者和对照组进行临床评估，包括 FIQ、HAQ 和压痛（TP）计数。通过结构化临床访谈（SCID）对终身或持续存在的精神方面进行评估。评估以下分析：细胞因子（IL1、IL2、IL6、IL8、IL10）、TNF-α、皮质醇、GH、ACTH、IGF1、5HT、细胞内镁、血浆钙 p（Ca）、PTH、（25（OH）D）和甲状腺功能。调查了一些典型症状。
81 名患者为痉挛性疾病阳性（FM+SP），233 名患者为痉挛性疾病阴性（FM）。FM 组的平均 TP 数较高（15.33±3.88），而 FM+SP 组较低（12.88±6.17，p=0.016），而 FIQ 和 HAQ 在两组之间没有差异。FM 患者比 FM+SP 患者更频繁地出现精神障碍（72% FM 比 49% FM+SP，p<0.01）。特别是抑郁症的发生率为 65.5% FM 比 35% FM+SP（p<0.01）。
痉挛性疾病的存在似乎会影响精神共病，FM+SP 患者的精神共病发生率较低。FM 确实以疼痛的异常感觉处理为特征，这种处理似乎是由神经递质、应激、激素和神经系统之间的相互作用共同作用的结果；痉挛性疾病似乎与神经肌肉水平的功能障碍更为相关。
