Bombardier C H, Buchwald D
Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, USA.
Arch Intern Med. 1995 Oct 23;155(19):2105-10.
There are few data on the natural history and prognosis of persons with chronic fatigue (CF) or CF syndrome (CFS). Therefore, we compared functional outcomes in patients with each condition and tested the validity of various prognostic indicators.
Four hundred forty-five (89%) of 498 consecutive referral patients were surveyed an average of 1.5 years after an initial evaluation. Data from the initial evaluation were used to predict outcomes.
Sixty-four percent of all patients reported improvement, but only 2% reported complete resolution of symptoms. Patients initially diagnosed as having CFS reported greater symptom severity and lower level of functioning at follow-up than did patients with CF. Major depression predicted unemployment in the CF group. Older age, longer duration of illness, and a lifetime history of dysthymia predicted less improvement in the CF group. Current dysthymia predicted less improvement for the CFS group.
The case definition of CFS according to the Centers for Disease Control and Prevention identifies chronically fatigued patients with poorer prognosis. In a tertiary care setting, recovery from CF or CFS is rare, but improvement is common. Prognostic indicators vary for the two groups, but the coexistence of dysthymia suggests poorer outcomes generally.
关于慢性疲劳（CF）或慢性疲劳综合征（CFS）患者的自然病史和预后的数据很少。因此，我们比较了每种疾病患者的功能结局，并测试了各种预后指标的有效性。
对498例连续转诊患者中的445例（89%）在初次评估后平均1.5年进行了调查。初次评估的数据用于预测结局。
所有患者中有64%报告症状有所改善，但只有2%报告症状完全缓解。最初被诊断为患有CFS的患者在随访时报告的症状严重程度更高，功能水平低于CF患者。重度抑郁症预示着CF组患者会失业。年龄较大、病程较长以及有心境恶劣病史预示着CF组患者改善较少。当前的心境恶劣预示着CFS组患者改善较少。
根据疾病控制与预防中心的定义，CFS的病例识别出预后较差的慢性疲劳患者。在三级医疗环境中，从CF或CFS中恢复的情况很少见，但改善情况很常见。两组的预后指标各不相同，但心境恶劣的并存通常预示着预后较差。
