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小儿麻痹后遗症与肌痛性脑脊髓炎及慢性疲劳综合征的鉴别诊断

Differentiating Post-Polio Syndrome from Myalgic Encephalomyelitis and Chronic Fatigue Syndrome.

作者信息

Klebek Lauren, Sunnquist Madison, Jason Leonard A

机构信息

Center for Community Research, DePaul University.

出版信息

Fatigue. 2019;7(4):196-206. doi: 10.1080/21641846.2019.1687117. Epub 2019 Nov 6.

Abstract

BACKGROUND

Overlapping and concomitant symptoms among similar chronic illnesses have created difficulties for diagnosis and further treatment. Three such chronically fatiguing illnesses, Post-polio syndrome (PPS), Myalgic Encephalomyelitis (ME) and chronic fatigue syndrome (CFS) fall under this category.

PURPOSE

The aim of this study is to examine and distinguish between core symptoms found in these illnesses (i.e. muscle pain/weakness, fatigue or exhaustion, and autonomic symptoms) via three methods of analysis (DePaul Symptom Questionnaire 2 (DSQ-2), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and machine learning techniques).

RESULTS

Items assessing onset and severity for individuals who reported having PPS were found to have experienced an onset of PPS related symptoms roughly 30 years after the onset of Polio. Items found in the DSQ-2, SF-36 compared all illness groups and found that participants with ME/CFS were more functionally impaired across symptoms than those with PPS. Across all analyses, three domains most commonly differentiated the illnesses (neurocognitive, Post-exertional malaise, and neuroendocrine).

CONCLUSION

Examining functional impairment amongst chronically fatiguing illnesses using multiple methods of analysis can be an important factor in distinguishing similar illnesses. These findings support further analysis of analogous symptomatology among other chronic illnesses to assist in diagnosis.

摘要

背景

相似的慢性疾病存在重叠和伴随症状,给诊断和进一步治疗带来了困难。三种此类慢性疲劳疾病,即小儿麻痹后遗症(PPS)、肌痛性脑脊髓炎(ME)和慢性疲劳综合征(CFS)都属于这一类别。

目的

本研究的目的是通过三种分析方法(德保罗症状问卷2(DSQ - 2)、医学结局研究36项简短健康调查(SF - 36)和机器学习技术)来检查和区分这些疾病中发现的核心症状(即肌肉疼痛/无力、疲劳或疲惫以及自主神经症状)。

结果

对于报告患有PPS的个体,评估发病时间和严重程度的项目发现,PPS相关症状的发病时间大约在小儿麻痹症发病后30年。DSQ - 2、SF - 36中的项目对所有疾病组进行了比较,发现与PPS患者相比,ME/CFS患者在各种症状上的功能损害更大。在所有分析中,三个领域最常区分这些疾病(神经认知、运动后不适和神经内分泌)。

结论

使用多种分析方法检查慢性疲劳疾病中的功能损害可能是区分相似疾病的一个重要因素。这些发现支持对其他慢性疾病中的类似症状进行进一步分析以辅助诊断。

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