Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Department of Medicine, Lagos State University Teaching Hospital, Lagos State, Nigeria.
Int J Rheum Dis. 2020 Jul;23(7):970-976. doi: 10.1111/1756-185X.13865. Epub 2020 May 31.
To describe the characteristics of fibromyalgia among Nigerian patients and assess the sensitivities of the American College of Rheumatology (ACR) criteria of 1990, 2010, 2011, and 2016 for making the diagnosis of fibromyalgia.
Consecutive patients diagnosed clinically with fibromyalgia by a rheumatologist were assessed. ACR criteria for fibromyalgia of 1990, 2010, 2011, and 2016 were applied to each patient. Polysymptomatic distress scores (PSD) were calculated from the Widespread Pain Index and Symptom Severity Scores. Sleep was assessed using the Pittsburgh Sleep Quality Index; fatigue by the Fatigue Severity Scale and the severity of fibromyalgia was determined using the Revised Fibromyalgia Impact Questionnaire (FIQR).
A total of 660 new patients were seen out of which a diagnosis of fibromyalgia was made in 114 (17.3%). The mean age of the patients was 44.6 ± 15.6 years and females accounted for 84.2%. Twenty-one (18.4%) patients had changed or quit their jobs due to fibromyalgia. Problematic fatigue was present in 80 (70.2%), and sleep disturbance was reported in 83 (72.8%) patients. The severity of fibromyalgia, poor sleep, severe or very severe PSD, and male gender were associated with problematic fatigue, but only moderate/severe fibromyalgia independently predicted problematic fatigue (P = .004). The number of tender points (P = .001) and FIQR score (P = .038) were associated with changing or quitting jobs. The sensitivities of the ACR1990, ACR2010, ACR2011 and ACR2016 were 38.5%, 68.2%, 76.7% and 76.7%, respectively.
The ACR1990 had low sensitivity when used to diagnose fibromyalgia in this population and the ACR2010 encounters problems while applying the somatic symptom list.
描述尼日利亚患者纤维肌痛的特征，并评估美国风湿病学会（ACR）1990 年、2010 年、2011 年和 2016 年标准诊断纤维肌痛的敏感性。
评估由风湿病医生临床诊断为纤维肌痛的连续患者。将 1990 年、2010 年、2011 年和 2016 年 ACR 纤维肌痛标准应用于每位患者。从广泛性疼痛指数和症状严重程度评分计算多症状困扰评分（PSD）。使用匹兹堡睡眠质量指数评估睡眠；使用疲劳严重程度量表评估疲劳；使用修订后的纤维肌痛影响问卷（FIQR）确定纤维肌痛的严重程度。
共观察到 660 例新患者，其中 114 例（17.3%）诊断为纤维肌痛。患者的平均年龄为 44.6±15.6 岁，女性占 84.2%。21 名（18.4%）患者因纤维肌痛而改变或辞去工作。80 名（70.2%）患者存在问题性疲劳，83 名（72.8%）患者报告睡眠障碍。纤维肌痛的严重程度、睡眠不佳、严重或非常严重的 PSD 和男性与问题性疲劳相关，但只有中重度纤维肌痛独立预测问题性疲劳（P=0.004）。压痛点数（P=0.001）和 FIQR 评分（P=0.038）与改变或辞去工作有关。ACR1990、ACR2010、ACR2011 和 ACR2016 的敏感性分别为 38.5%、68.2%、76.7%和 76.7%。
在该人群中，ACR1990 用于诊断纤维肌痛的敏感性较低，而 ACR2010 在应用躯体症状清单时遇到问题。
