Creed Francis
Neuroscience and Mental Health, University of Manchester, Manchester, United Kingdom.
Pain. 2020 Jun;161(6):1169-1176. doi: 10.1097/j.pain.0000000000001819.
This review identified prospective cohort studies in the general population, which showed incidence (23 papers) and risk factors (37 papers) for fibromyalgia and chronic widespread pain. Median incidence of physician diagnosed fibromyalgia in the general population was 4.3 per 1000 person-years (range = 0.33-18.8) but 14.0 (1.2-32.7) if medical illness was present. Median incidence of chronic widespread pain was 12.5 per 1000 person-years (7.2-81.6) but 67 per 1000 person years (14.8-124) for those with pre-existing pain. Risk factors included various childhood difficulties, female sex (except with pre-existing medical disorders), older/middle age, smoking, high body mass index, alcohol abstinence, and pre-existing medical disorders in adulthood. The strongest associations were with sleep disorders, headaches and other pains, depression, and illness behaviour. These data suggest strongly that there are many aetiological routes into fibromyalgia, and future research could be enhanced by studying the underlying mechanisms relating to these risk factors.
本综述纳入了针对普通人群的前瞻性队列研究，这些研究显示了纤维肌痛和慢性广泛性疼痛的发病率（23篇论文）及风险因素（37篇论文）。普通人群中经医生诊断的纤维肌痛发病率中位数为每1000人年4.3例（范围 = 0.33 - 18.8），但如果存在内科疾病则为14.0例（1.2 - 32.7）。慢性广泛性疼痛的发病率中位数为每1000人年12.5例（7.2 - 81.6），但对于已有疼痛的人群则为每1000人年67例（14.8 - 124）。风险因素包括各种童年困难、女性（已有内科疾病者除外）、中老年、吸烟、高体重指数、戒酒以及成年期已有内科疾病。最强的关联因素是睡眠障碍、头痛和其他疼痛、抑郁以及患病行为。这些数据有力地表明，纤维肌痛有多种病因途径，未来通过研究与这些风险因素相关的潜在机制，有望加强研究。
