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对肌痛性脑脊髓炎/慢性疲劳综合征患者的异质性国际样本进行潜在类别分析。

Latent class analysis of a heterogeneous international sample of patients with myalgic encephalomyelitis/chronic fatigue syndrome.

作者信息

Huber Kayla A, Sunnquist Madison, Jason Leonard A

机构信息

Center for Community Research, DePaul University, 990 W. Fullerton Ave. Suite 3101, Chicago, IL 60614,

出版信息

Fatigue. 2018;6(3):163-178. doi: 10.1080/21641846.2018.1494530. Epub 2018 Jul 4.

Abstract

BACKGROUND

Individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) routinely display differences in symptomatology, as well as illness course, onset, duration, and functional disability. Given such diversity, previous work has attempted to identify symptom-based ME/CFS subtypes. However, results have been inconsistent.

PURPOSE

This study sought to elucidate potential subtypes of ME/CFS as well as explore the impact of subtype membership on health functioning.

METHODS

Twelve non-core (i.e., less frequently endorsed) symptoms were included in a latent class analysis of 1,210 adults with ME/CFS. Demographic and illness-related predictors of class membership were evaluated with a multinomial logistic regression. ANOVAs were then performed to determine if there were significant differences across class on the eight subscales of the Short-Form Health Survey (SF-36).

RESULTS

A six-class solution was selected, which consisted of one class that was likely to endorse all non-core symptoms, one class that was unlikely to endorse any non-core symptoms, and four classes that were likely to endorse either one or two non-core symptom domains (i.e., circulatory/neuroendocrine impairment, orthostatic intolerance, and gastro-intestinal distress). Significant functioning differences by class were present for all SF-36 subscales.

CONCLUSIONS

These results are suggestive of subtypes of ME/CFS and, if replicated, may assist physicians in providing tailored treatment to patients and allow researchers to form more homogeneous samples.

摘要

背景

肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)患者在症状表现、病程、发病情况、持续时间以及功能残疾方面通常存在差异。鉴于这种多样性,此前的研究试图确定基于症状的ME/CFS亚型。然而,结果并不一致。

目的

本研究旨在阐明ME/CFS的潜在亚型,并探讨亚型归属对健康功能的影响。

方法

对1210名患有ME/CFS的成年人进行潜在类别分析,纳入12种非核心(即较少被认可)症状。通过多项逻辑回归评估类别归属的人口统计学和疾病相关预测因素。然后进行方差分析,以确定在简短健康调查(SF - 36)的八个分量表上各类别之间是否存在显著差异。

结果

选择了一个六类别解决方案,其中包括一个可能认可所有非核心症状的类别、一个不太可能认可任何非核心症状的类别,以及四个可能认可一个或两个非核心症状领域(即循环/神经内分泌功能受损、体位性不耐受和胃肠道不适)的类别。所有SF - 36分量表在各类别之间均存在显著的功能差异。

结论

这些结果提示了ME/CFS的亚型,若能重复验证,可能有助于医生为患者提供个性化治疗,并使研究人员能够形成更具同质性的样本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77e/6703845/1b04d89630fd/nihms-1514860-f0001.jpg

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