Shapoval Iryna, Stanislavchuk Mykola
Assistant of Internal Medicine Chair #1, National Pirogov Memorial Medical University, Vinnytsya Pirogova str. 56, Vinnytsya, 21018, Ukraine.
Head of Internal Medicine Chair #1, National Pirogov Memorial Medical University, Vinnytsya Pirogova str. 56, Vinnytsya, 21018, Ukraine.
Rheumatol Int. 2023 Jan;43(1):69-77. doi: 10.1007/s00296-022-05168-3. Epub 2022 Jul 23.
Despite many approaches, diagnosis of fibromyalgia (FM) remains a difficult clinical task, especially in the case of comorbidity of FM with other rheumatic diseases, such as ankylosing spondylitis (AS). The prevalence of FM among the population is 2.9-4.7%; whereas in patients with AS, it increases to 12.6-28.5%. The aim of the study was to evaluate the prevalence of FM in AS patients according to different criteria and to characterize them. 143 patients with AS, according to the modified New York Criteria, were examined. The FiRST used for screening of a possible FM. The FM was detected using the ACR 1990 criteria, mARC 2010, ACR 2016 and AAPT 2019 diagnostic criteria. All data were analyzed using IBM Statistics SPSS 22 software. The study was carried out in compliance with bioethical standards. According to ACR 1990, mACR 2010, ACR 2016, and AAPT 2019, the prevalence of FM in patients with AS ranged from 21.0% to 35.7%. The strongest correlation was observed in the mACR 2010 and ACR 2016 criteria (Cohen's κ = 0.871, p < 0.001); ACR 1990 and mACR 2010 as well as ACR 2016 criteria also demonstrated quite a strong level of agreement (Cohen's κ = 0.675 and 0.684, p < 0.001). Our results showed a high prevalence of FM in AS patients. mACR 2010 and ACR 2016 criteria are optimal for clinical practice to diagnose FM in AS patients.
尽管有多种方法，但纤维肌痛（FM）的诊断仍然是一项艰巨的临床任务，尤其是在FM与其他风湿性疾病如强直性脊柱炎（AS）合并存在的情况下。FM在人群中的患病率为2.9%-4.7%；而在AS患者中，其患病率则升至12.6%-28.5%。本研究的目的是根据不同标准评估AS患者中FM的患病率并对其进行特征描述。根据改良纽约标准，对143例AS患者进行了检查。使用FiRST筛查可能的FM。采用美国风湿病学会（ACR）1990年标准、改良ACR（mARC）2010年标准、ACR 2016年标准和美国疼痛学会（AAPT）2019年诊断标准检测FM。所有数据均使用IBM Statistics SPSS 22软件进行分析。本研究按照生物伦理标准开展。根据ACR 1990年标准、mACR 2010年标准、ACR 2016年标准和AAPT 2019年标准，AS患者中FM的患病率在21.0%至35.7%之间。在mACR 2010年标准和ACR 2016年标准之间观察到最强的相关性（科恩kappa系数=0.871，p<0.001）；ACR 1990年标准与mACR 2010年标准以及ACR 2016年标准之间也显示出相当高的一致性水平（科恩kappa系数分别为0.675和0.684，p<0.001）。我们的结果显示AS患者中FM的患病率较高。mACR 2010年标准和ACR 2016年标准是临床实践中诊断AS患者FM的最佳标准。
